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Organization
LEGACY DENTAL IMPLANT
Active
Organization
LEGACY DENTAL IMPLANT
Active
Other names
Legacy dental implant, legacy dental implant
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AHMED MATRI (OWNER)
(646) 824-3829
Entity
Organization
Contact information
Practice address
3000 10TH ST N, ARLINGTON, VA 22201-2162
(646) 824-3829
Mailing address
3000 10TH ST N, ARLINGTON, VA 22201-2162
(646) 824-3829
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223E0200X
Endodontics
—
—
1223P0300X
Periodontics
Primary
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
06/27/2024
Last updated
06/27/2024
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