Legacy Dental LLC
NPI #1083704019 in Fort Wayne, Indiana
Provider Information
- NPI Number
- 1083704019
- Entity Type
- Organization
- Organization Name
- Legacy Dental LLC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Oct 13, 2006
- Last Updated
- Aug 17, 2020
Practice Location
- Address
- 7215 ENGLE RD.
- City
- Fort Wayne
- State
- Indiana
- ZIP Code
- 46804
- Phone
- (260) 434-1133
Authorized Official
- Name
- MR. NATHAN JAMES BOJRAB
- Title
- CEO
- Phone
- (260) 434-1133
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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