OrganizationActive
Legacy Family Dental of Bountiful LLC
NPI 1275859589 · Health Maintenance Organization · Bountiful, UT
Provider details
- NPI number
- 1275859589
- Entity type
- Organization
- Primary specialty
- Health Maintenance OrganizationManaged Care Organizations
- Organization subpart
- No
- Authorized official
- Kase Peery, Owner/Managing Member(801) 870-0838
- License
- 75313980160 (UT)
Specialties & taxonomies
Managed Care Organizations
Practice location
55 E 2200 S
Bountiful, UT 84010-5619
Phone: (801) 295-5115
Fax: (801) 397-5559
Approximate (ZIP-level) locationGet directions
Mailing address
55 E 2200 S
Bountiful, UT 84010-5619
Registry dates
- Enumerated
- 2010-04-12
- Last updated
- 2010-04-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.