# LEGACY DENTAL P.C.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720144967
- **Authorized official:** DR. PHILLIP TRACY BRIGDEN D.D.S. (PRESIDENT)
- **Authorized official phone:** (402) 393-1108

## Contact information

- **Practice address:** 17602 WRIGHT ST, SUITE 105, OMAHA, NE 68130-2097
- **Practice address phone:** (402) 393-1108
- **Practice address fax:** (402) 393-1184
- **Mailing address:** 17602 WRIGHT ST, SUITE 105, OMAHA, NE 68130-2097
- **Mailing address phone:** (402) 393-1108
- **Mailing address fax:** (402) 393-1184

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 5969 | NE | Yes |

## Other

- **Enumeration date:** 12/30/2006
- **Last updated:** 08/22/2020