# HERZOG LEGACY PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** FLOSS
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578858163
- **Authorized official:** DR. CLINT HERZOG DDS (CEO/PRESIDENT)
- **Authorized official phone:** (214) 871-7100

## Contact information

- **Practice address:** 5800 LEGACY DR STE C8, PLANO, TX 75024-7101
- **Practice address phone:** (469) 368-0101
- **Practice address fax:** (469) 368-0102
- **Mailing address:** 5800 LEGACY DR STE C8, PLANO, TX 75024-7101
- **Mailing address phone:** (469) 368-0101
- **Mailing address fax:** (469) 368-0102

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 20239 | TX | Yes |

## Other

- **Enumeration date:** 06/13/2011
- **Last updated:** 07/07/2011