Organization
MODERN LEGACY, INC.
Active
Other names
Latta Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
JACHELLE AG SPRATTLING DMD (SECRETARY)
(843) 810-4259
Entity
Organization
Contact information
Practice address
203 S MARION ST, LATTA, SC 29565-1522
(843) 752-7655
(843) 752-4500
Mailing address
203 S MARION ST, LATTA, SC 29565-1522
(843) 752-7655
(843) 752-4500
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/04/2009
Last updated
08/05/2024
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