MODERN LEGACY INC. NPI 1992032486

NPI Information

  • NPI: 1992032486
  • Provider Name: MODERN LEGACY, INC.
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Organization
  • Doing Business As: LATTA FAMILY DENTISTRY
  • Address: 203 S MARION ST
    LATTA, SC
    ZIP 29565
  • Phone: (843) 752-7655

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NPI Details

MODERN LEGACY, INC. is a general practice dentist in Latta, SC. 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. MODERN LEGACY, INC. NPI is 1992032486. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Latta Family Dentistry.

The provider's business location address is:

203 S MARION ST
LATTA, SC
ZIP 29565-522
Phone: (843) 752-7655
Fax: (843) 752-4500

The provider's authorized official is Jachelle Ag Sprattling .
The authorized official title is Secretary and has the following contact phone number (843) 810-4259.

The enumeration date for this NPI number is 11/4/2009 and was last updated on 8/5/2024.

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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral PracticeYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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