Legacy Dental Studio, LLC
NPI #1851118475 in Inlet Beach, Florida
Provider Information
- NPI Number
- 1851118475
- Entity Type
- Organization
- Organization Name
- Legacy Dental Studio, LLC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Sep 24, 2024
- Last Updated
- Sep 24, 2024
Practice Location
- Address
- 50 ORIGINS MAIN STREET
- Address 2
- SUITE 200
- City
- Inlet Beach
- State
- Florida
- ZIP Code
- 32461
- Phone
- (850) 818-9006
Authorized Official
- Name
- REESE HARRISON, DMD
- Title
- MANAGER/PROVIDER
- Phone
- (850) 818-9006
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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