| Moore Legacy Dental | |
|
4896 S 1900 W Ste B Roy UT 84067-2994 | |
| (801) 773-9198 | |
| (208) 444-9804 |
| Full Name | Moore Legacy Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 4896 S 1900 W Ste B, Roy, Utah |
| Authorized Official Name and Position | Elise Nicole Van Tassell (OWNER) |
| Authorized Official Contact | 3852390028 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Moore Legacy Dental 4896 S 1900 W Ste B Roy UT 84067-2994 Ph: (801) 773-9198 | Moore Legacy Dental 4896 S 1900 W Ste B Roy UT 84067-2994 Ph: (801) 773-9198 |
| NPI Number | 1649952086 |
|---|---|
| Provider Enumeration Date | 08/04/2023 |
| Last Update Date | 08/04/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649952086 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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Pediatric Dental & Orthodontics Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3485 W 4800 S, Roy, UT 84067 Phone: 801-774-5437 Fax: 801-774-9440 | |
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Midland Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 4040 South Midland Drive, Suite 1, Roy, UT 84067 Phone: 801-317-4407 Fax: 801-605-8304 | |
Paul D Hopkins Dds Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 4902 S 1900 W Suite 2, Roy, UT 84067 Phone: 801-773-1234 Fax: 801-773-9611 | |
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