LEGACY DENTAL NPI 1841204609

NPI Information

LEGACY DENTAL is a general practice dentist in Idaho Falls, ID. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. LEGACY DENTAL NPI is 1841204609. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

1685 PANCHERI DR
IDAHO FALLS, ID
ZIP 83402-169
Phone: (208) 523-0840
Fax: (208) 523-0921

The provider's authorized official is Oliver Oneal Thuernagle .
The authorized official title is Dentist and has the following contact phone number (208) 523-0840.

The enumeration date for this NPI number is 7/28/2006 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:

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