Organization
LEGACY DENTAL SOLUTIONS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXIS IRBY-JOHNSON (OWNER)
(470) 205-8802
Entity
Organization
Contact information
Practice address
3133 HIGHWAY 278 NE, COVINGTON, GA 30014-2301
(470) 205-8802
Mailing address
PO BOX 70887, CLEVELAND, OH 44190-0887
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
04/27/2022
Last updated
06/20/2023
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