Organization
LEGACY DENTAL PARTNERS LLC
Active
Other names
Legacy Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEWART ANDERSON DMD (PARTNER)
(505) 314-6526
Entity
Organization
Contact information
Practice address
5343 WYOMING BLVD NE, STE A, ALBUQUERQUE, NM 87109-3199
(505) 822-8777
Mailing address
5343 WYOMING BLVD NE, STE A, ALBUQUERQUE, NM 87109-3199
(505) 822-8777
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DD3103
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01076370
—
NM
Enumeration date
11/11/2016
Last updated
11/11/2016
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