Legacy Dental Care, Llc | |
17602 Wright St Suite 105 Omaha NE 68130-2097 | |
(402) 393-1108 | |
Not Available |
Full Name | Legacy Dental Care, Llc |
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Speciality | Dentist - General Practice |
Location | 17602 Wright St, Omaha, Nebraska |
Authorized Official Name and Position | Brent Jamison Rising (OWNER) |
Authorized Official Contact | 7017996453 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Legacy Dental Care, Llc 14406 Harrison St Omaha NE 68138-6521 Ph: (402) 333-1120 | Legacy Dental Care, Llc 17602 Wright St Suite 105 Omaha NE 68130-2097 Ph: (402) 393-1108 |
NPI Number | 1427500859 |
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Provider Enumeration Date | 11/02/2016 |
Last Update Date | 11/02/2016 |
Identifier | Type | State | Issuer |
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1427500859 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223G0001X | Dentist - General Practice | 6812 (Nebraska) | Primary |
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