Legacy Dental
NPI #1841204609 in Idaho Falls, Idaho
Provider Information
- NPI Number
- 1841204609
- Entity Type
- Organization
- Organization Name
- Legacy Dental
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Jul 28, 2006
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 1685 PANCHERI DR
- City
- Idaho Falls
- State
- Idaho
- ZIP Code
- 83402-3169
- Phone
- (208) 523-0840
Authorized Official
- Name
- OLIVER ONEAL THUERNAGLE, DMD
- Title
- DENTIST
- Phone
- (208) 523-0840
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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