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Organization
IVODENT GROUP PLLC
Active
Organization
IVODENT GROUP PLLC
Active
Other names
Legacy Park Dental
Organization subpart
No
Provider details
NPI number
Authorized official
JACKI DANG (PRACTICE MANAGER)
(817) 703-3791
Entity
Organization
Contact information
Practice address
1001 NE GREEN OAKS BLVD, 129, ARLINGTON, TX 76006-2318
(817) 789-4480
Mailing address
1001 NE GREEN OAKS BLVD, 129, ARLINGTON, TX 76006-2318
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/15/2014
Last updated
10/15/2014
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