Provider Demographics
NPI:1396222188
Name:LEGGIO DENTAL GROUP, APDC
Entity Type:Organization
Organization Name:LEGGIO DENTAL GROUP, APDC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEGGIO-PUTNAM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:504-899-1556
Mailing Address - Street 1:4914 MAGAZINE ST.
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115
Mailing Address - Country:US
Mailing Address - Phone:504-899-1556
Mailing Address - Fax:888-508-7027
Practice Address - Street 1:4914 MAGAZINE ST.
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115
Practice Address - Country:US
Practice Address - Phone:504-899-1556
Practice Address - Fax:888-508-7027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-24
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty