Organization
LEGACY FAMILY DENTIST, PLLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALAN FORTENBERRY D.D.S. (MANAGER)
(405) 728-8400
Entity
Organization
Contact information
Practice address
8470 NW EXPRESSWAY, OKLAHOMA CITY, OK 73162-6009
(405) 728-8400
(405) 720-1777
Mailing address
8470 NW EXPRESSWAY, OKLAHOMA CITY, OK 73162-6009
(405) 728-8400
(405) 720-1777
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
6026
OK
Other
Enumeration date
05/26/2011
Last updated
05/26/2011
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