Legendary Orthodontics, Llc | |
3225 Audubon Dr Laurel MS 39440-1422 | |
(601) 778-0367 | |
(601) 340-3162 |
Full Name | Legendary Orthodontics, Llc |
---|---|
Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
Location | 3225 Audubon Dr, Laurel, Mississippi |
Authorized Official Name and Position | Kevin Douglas (OWNER) |
Authorized Official Contact | 9546005027 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Legendary Orthodontics, Llc 3225 Audubon Dr Laurel MS 39440-1422 Ph: (601) 778-0367 | Legendary Orthodontics, Llc 3225 Audubon Dr Laurel MS 39440-1422 Ph: (601) 778-0367 |
NPI Number | 1508359340 |
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Provider Enumeration Date | 06/06/2018 |
Last Update Date | 06/06/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1508359340 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Primary |
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