Organization
LEGACY DENTAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAKOB LEE DDS (DENTIST)
(616) 558-7928
Entity
Organization
Contact information
Practice address
2440 GAYNOR AVE NW, GRAND RAPIDS, MI 49544-1830
(616) 784-8444
Mailing address
2716 STERNER ST NW, GRAND RAPIDS, MI 49504-8100
(616) 558-7928
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/20/2025
Last updated
11/20/2025
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