| Legacy Dental Care Llc | |
|
12265 Central Ave Ne Blaine MN 55434-3961 | |
| (763) 757-1323 | |
| Not Available |
| Full Name | Legacy Dental Care Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 12265 Central Ave Ne, Blaine, Minnesota |
| Authorized Official Name and Position | Dennis L Parvey (DENTIST) |
| Authorized Official Contact | 7637571323 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Legacy Dental Care Llc 12265 Central Ave Ne Blaine MN 55434-3961 Ph: (763) 757-1323 | Legacy Dental Care Llc 12265 Central Ave Ne Blaine MN 55434-3961 Ph: (763) 757-1323 |
| NPI Number | 1336683036 |
|---|---|
| Provider Enumeration Date | 12/14/2016 |
| Last Update Date | 12/14/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336683036 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 8455 (Minnesota) | Primary |
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