LEGACY DENTAL GROUP NPI 1215953161

NPI Information

LEGACY DENTAL GROUP is a non pharmacy dispensing site in Glendale, AZ. The provider is a site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) LEGACY DENTAL GROUP NPI is 1215953161. The provider is registered as an organization entity type.
The provider Is Doing Business As Louis T Core Dds.

The provider's business location address is:

18205 N 51ST AVE STE 101
GLENDALE, AZ
ZIP 85308-491
Phone: (602) 993-4200
Fax: (602) 993-4222

The provider's authorized official is Louis Core .
The authorized official title is Dds and has the following contact phone number (602) 993-4200.

The enumeration date for this NPI number is 7/14/2006 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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