NPI 1215953161
Legacy Dental Group
Practice location
- Address
- 18205 N 51st Ave STE 101, Glendale, AZ 85308-1491
- Phone
- (602) 993-4200
- Fax
- (602) 993-4222
- Mailing address
- Poc Management LLC 3000 W Warner Ave, Santa Ana, CA 92704
Authorised official
- Name
- Louis Core
- Title
- DDS
- Phone
- (602) 993-4200
Registered specialties
Non-Pharmacy Dispensing Site
Primary
Registry record
- NPI
- 1215953161
- Entity type
- Organization
- NPI issued
- 14 Jul 2006
- Record last updated
- 22 Aug 2020
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.