Organization
LEGACY DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEWART J ANDERSON DMD (OWNER/DENTIST)
(505) 299-4431
Entity
Organization
Contact information
Practice address
4520 LOWER TERRACE CIR NE, ALBUQUERQUE, NM 87111-2503
(505) 299-4431
(505) 291-0265
Mailing address
4520 LOWER TERRACE CIR NE, ALBUQUERQUE, NM 87111-2503
(505) 299-4431
(505) 291-0265
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DD3103
NM
Other
Enumeration date
10/27/2014
Last updated
10/27/2014
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