| Legacy Dental Studio, Llc | |
|
50 Origins Main Street Suite 200 Inlet Beach FL 32461 | |
| (850) 818-9006 | |
| Not Available |
| Full Name | Legacy Dental Studio, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 50 Origins Main Street, Inlet Beach, Florida |
| Authorized Official Name and Position | Reese Harrison (MANAGER/PROVIDER) |
| Authorized Official Contact | 8508189006 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Legacy Dental Studio, Llc 50 Origins Main Street Suite 200 Inlet Beach FL 32461 Ph: (850) 818-9006 | Legacy Dental Studio, Llc 50 Origins Main Street Suite 200 Inlet Beach FL 32461 Ph: (850) 818-9006 |
| NPI Number | 1851118475 |
|---|---|
| Provider Enumeration Date | 09/24/2024 |
| Last Update Date | 09/24/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851118475 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
30a Smiles Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 12805 Us Highway 98 E, Suite K 201, Inlet Beach, FL 32413 Phone: 850-231-0070 |