# JOHN LEGLAGEN HALL

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1720187750
- **Gender:** Man
- **Credential:** DDS

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223D0001X | Public Health Dentistry | 2901016896 | MI | — |
| 1223G0001X | General Practice Dentistry | 019.023197 | IL | — |
| 1223G0001X | General Practice Dentistry | 12011912A | IN | — |
| 1223G0001X | General Practice Dentistry | 30.020619 | OH | Yes |

## Other

- **Enumeration date:** 09/22/2006
- **Last updated:** 01/07/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0317521 | — | OH |
| 05 | — | 201134060 | — | IN |
| 05 | — | 420322612 | — | MI |