Organization
LEGACY TRAILS DENTAL, PLLC
Active
Other names
LT Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AFSHIN AZMOODEH D.D.S. (MANAGER)
(214) 227-1000
Entity
Organization
Contact information
Practice address
4800 HEDGCOXE RD, SUITE # 150, PLANO, TX 75024-2403
(214) 227-1000
Mailing address
4800 HEDGCOXE RD, SUITE # 150, PLANO, TX 75024-2403
(214) 227-1000
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
04/14/2016
Last updated
04/14/2016
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