| NPI | 1780474627 |
|---|---|
| Doing Business As | LEGACY DENTAL STUDIO |
| Entity Type | Organization |
| Authorized Contact | CHARUTA MODAK Owner Dentist 410-561-8845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2025-05-12 |
| Last Update Date | 2025-05-19 |