| Legacy Orthodontics | |
|
3837 Vaile Ave Sutie G Florissant MO 63034 | |
| (314) 831-9399 | |
| (314) 831-8146 |
| Full Name | Legacy Orthodontics |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 3837 Vaile Ave, Florissant, Missouri |
| Authorized Official Name and Position | Karen Sue Mccann (PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 6182813399 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Legacy Orthodontics 3837 Vaile Ave Suite G Florissant MO 63034 Ph: (314) 831-9399 | Legacy Orthodontics 3837 Vaile Ave Sutie G Florissant MO 63034 Ph: (314) 831-9399 |
| NPI Number | 1720398910 |
|---|---|
| Provider Enumeration Date | 10/21/2010 |
| Last Update Date | 10/21/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720398910 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 31267 (Missouri) | Primary |
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