| NPI | 1740087006 |
|---|---|
| Doing Business As | LEGACY DENTAL CO. |
| Entity Type | Organization |
| Authorized Contact | JARVIS OWENS President 312-823-0410 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2025-02-25 |
| Last Update Date | 2025-02-25 |