Provider Demographics
NPI:1982288874
Name:LFD PLLC
Entity Type:Organization
Organization Name:LFD PLLC
Other - Org Name:LEGACY FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRASHER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:405-445-4016
Mailing Address - Street 1:8470 NW EXPRESSWAY
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73162-6009
Mailing Address - Country:US
Mailing Address - Phone:405-728-8400
Mailing Address - Fax:
Practice Address - Street 1:8470 NW EXPRESSWAY
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73162-6009
Practice Address - Country:US
Practice Address - Phone:405-445-4016
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-07
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty