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Legacy Dental Group
Non-Pharmacy Dispensing Site in Glendale, Arizona
NPI 1215953161

Legacy Dental Group is a Non-Pharmacy Dispensing Site based in Santa Ana, AZ. Legacy Dental Group practices in Glendale, AZ. The NPI Number for Legacy Dental Group is 1215953161 and holds a License No. D4729 (Arizona).

The current practice location address for Legacy Dental Group is 18205 N 51St Ave Ste 101, Glendale, AZ and can be reached out via phone at 602-993-4200 and via fax at 602-993-4222.

Location: 18205 N 51St Ave Ste 101, Glendale, AZ, 92704
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1215953161
Provider Name
Legacy Dental Group
Credential
Provider Entity Type
Organization
Address
18205 N 51St Ave Ste 101, Glendale, AZ, 92704
Phone Number
602-993-4200
Fax Number
602-993-4222
Provider Enumeration Date
07/14/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0353324 01 OTHER ID NUMBER-COMMERCIAL NUMBER
institution
Provider Business Practice Location Address Details
Address
18205 N 51St Ave Ste 101
City
Glendale
State
Arizona
Zip
85308-1491
Phone Number
602-993-4200
Fax Number
602-993-4222
person
Provider Business Mailing Address Details
Address
18205 N 51St Ave Ste 101
City
Glendale
State
Arizona
Zip
85308-1491
Phone Number
602-993-4200
Fax Number
602-993-4222
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Non-Pharmacy Dispensing Site
Speciality
-
Taxonomy
332900000X
License No.
D4729 (Arizona)
Definition
A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)
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