Moore Legacy Dental

NPI #1649952086 in Roy, Utah

Provider Information

NPI Number: 1649952086
Entity Type: Organization
Organization Name: Moore Legacy Dental
Primary Specialty: Clinic/Center - Dental
Enumeration Date: Aug 4, 2023
Last Updated: Aug 4, 2023

Practice Location

Address: 4896 S 1900 W STE B
City: Roy
State: Utah
ZIP Code: 84067-2994
Phone: (801) 773-9198

Authorized Official

Name: MRS. ELISE NICOLE VAN TASSELL
Title: OWNER
Phone: (385) 239-0028

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Dental — Dental	261QD0000X	Primary

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