OrganizationActive
Legendary Orthodontics, LLC
NPI 1508359340 · Orthodontics and Dentofacial Orthopedics Dentistry · Laurel, MS
Provider details
- NPI number
- 1508359340
- Entity type
- Organization
- Primary specialty
- Orthodontics and Dentofacial Orthopedics DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Kevin Douglas, Owner(954) 600-5027
Specialties & taxonomies
Dental Providers
Practice location
3225 Audubon Dr
Laurel, MS 39440-1422
Phone: (601) 778-0367
Fax: (601) 340-3162
Approximate (ZIP-level) locationGet directions
Mailing address
3225 Audubon Dr
Laurel, MS 39440-1422
Registry dates
- Enumerated
- 2018-06-06
- Last updated
- 2018-06-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.