Organization
LEGACY DENTAL P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHILLIP TRACY BRIGDEN D.D.S. (PRESIDENT)
(402) 393-1108
Entity
Organization
Contact information
Practice address
17602 WRIGHT ST, SUITE 105, OMAHA, NE 68130-2097
(402) 393-1108
(402) 393-1184
Mailing address
17602 WRIGHT ST, SUITE 105, OMAHA, NE 68130-2097
(402) 393-1108
(402) 393-1184
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5969
NE
Other
Enumeration date
12/30/2006
Last updated
08/22/2020
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