Modern Legacy, Inc.
NPI #1992032486 in Latta, South Carolina
Provider Information
- NPI Number
- 1992032486
- Entity Type
- Organization
- Organization Name
- Modern Legacy, Inc.
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Nov 4, 2009
- Last Updated
- Aug 5, 2024
Practice Location
- Address
- 203 S MARION ST
- City
- Latta
- State
- South Carolina
- ZIP Code
- 29565-1522
- Phone
- (843) 752-7655
Authorized Official
- Name
- JACHELLE AG SPRATTLING, DMD
- Title
- SECRETARY
- Phone
- (843) 810-4259
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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