| Viv Legacy PLLC | |
|
199 Blossom St Webster TX 77598-4414 | |
| (848) 466-6909 | |
| Not Available |
| Full Name | Viv Legacy PLLC |
|---|---|
| Speciality | Dentist |
| Location | 199 Blossom St, Webster, Texas |
| Authorized Official Name and Position | Vishal Dhatrak (DENTIST) |
| Authorized Official Contact | 8484666909 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Viv Legacy PLLC 199 Blossom St Webster TX 77598-4414 Ph: (848) 466-6909 | Viv Legacy PLLC 199 Blossom St Webster TX 77598-4414 Ph: (848) 466-6909 |
| NPI Number | 1588430706 |
|---|---|
| Provider Enumeration Date | 11/29/2023 |
| Last Update Date | 11/29/2023 |
| Certification Date | 11/29/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588430706 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | () | Primary |
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