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Organization

LEGACY DENTAL CARE, LLC

Active
Parent organization
BRENT J. RISING, DDS PC
Organization subpart
Yes

Provider details

NPI number
Legal business name
BRENT J. RISING, DDS PC
Authorized official
DR. BRENT JAMISON RISING DDS (OWNER)
(701) 799-6453
Entity
Organization

Contact information

Practice address
17602 WRIGHT ST, SUITE 105, OMAHA, NE 68130-2097
(402) 393-1108
Mailing address
14406 HARRISON ST, OMAHA, NE 68138-6521
(402) 333-1120
(402) 697-8713

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6812
NE

Other

Enumeration date
11/02/2016
Last updated
11/02/2016
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