| Legacy Dental Care Pc | |
|
3900 Legacy Park Blvd Nw Suite D-100 Kennesaw GA 30144-7412 | |
| (770) 424-7008 | |
| Not Available |
| Full Name | Legacy Dental Care Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3900 Legacy Park Blvd Nw, Kennesaw, Georgia |
| Authorized Official Name and Position | Seth Patt (OWNER) |
| Authorized Official Contact | 7704247008 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Legacy Dental Care Pc 3900 Legacy Park Blvd Nw Suite D-100 Kennesaw GA 30144-7412 Ph: (770) 424-7008 | Legacy Dental Care Pc 3900 Legacy Park Blvd Nw Suite D-100 Kennesaw GA 30144-7412 Ph: (770) 424-7008 |
| NPI Number | 1891812251 |
|---|---|
| Provider Enumeration Date | 03/23/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891812251 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 012030 (Georgia) | Primary |
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