| Legacy Oral And Maxillofacial Surgery | |
|
2500 Legacy Dr Suite 230 Frisco TX 75034-5983 | |
| (214) 387-4900 | |
| Not Available |
| Full Name | Legacy Oral And Maxillofacial Surgery |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 2500 Legacy Dr, Frisco, Texas |
| Authorized Official Name and Position | Jason Nicholas Stamboulieh (PRESIDENT) |
| Authorized Official Contact | 2143851476 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Legacy Oral And Maxillofacial Surgery Po Box 6200 Frisco TX 75035-0228 Ph: (214) 385-1476 | Legacy Oral And Maxillofacial Surgery 2500 Legacy Dr Suite 230 Frisco TX 75034-5983 Ph: (214) 387-4900 |
| NPI Number | 1568625721 |
|---|---|
| Provider Enumeration Date | 07/08/2008 |
| Last Update Date | 07/23/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568625721 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 21740 (Texas) | Primary |
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