| Legacy Dental Center | |
|
148 State Route 775 Proctorville OH 45669-8839 | |
| (740) 886-7000 | |
| (740) 886-5518 |
| Full Name | Legacy Dental Center |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 148 State Route 775, Proctorville, Ohio |
| Authorized Official Name and Position | Melanie Lynn Blevins (DENTIST/OWNER) |
| Authorized Official Contact | 7408867000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Legacy Dental Center Po Box 459 Proctorville OH 45669-0459 Ph: (740) 886-7000 | Legacy Dental Center 148 State Route 775 Proctorville OH 45669-8839 Ph: (740) 886-7000 |
| NPI Number | 1053409490 |
|---|---|
| Provider Enumeration Date | 10/11/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053409490 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 21386 (Ohio) | Primary |
| 1223G0001X | Dentist - General Practice | 3484 (West Virginia) | Secondary |
Proctorville Health Care Center Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 10777 County Road 107, Proctorville, OH 45669 Phone: 740-302-0541 Fax: 740-886-0255 | |
Proctorville Health Care Center Dental Clinic Medicare: Medicare Enrolled Practice Location: 10777 County Road 107, Proctorville, OH 45669 Phone: 740-302-0541 Fax: 740-886-0255 |