Organization
LEGENDARY DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LOGAN TRAVIS VEATH DDS (DENTIST/OWNER)
(712) 340-0333
Entity
Organization
Contact information
Practice address
1809 21ST ST, HARLAN, IA 51537-1828
(712) 340-0333
Mailing address
1809 21ST ST, HARLAN, IA 51537-1828
(712) 340-0333
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1366821183
—
IA
Enumeration date
01/07/2019
Last updated
01/07/2019
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