Organization
LEGACY DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMER MANSOUR DDS (DENTIST)
(814) 746-3327
Entity
Organization
Contact information
Practice address
5127 ZUCK RD, ERIE, PA 16506-4941
(814) 746-3327
Mailing address
5127 ZUCK RD, ERIE, PA 16506-4941
(814) 746-3327
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
—
—
Other
Enumeration date
11/14/2020
Last updated
03/10/2021
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