Provider Demographics
NPI:1306338249
Name:LEGASPI, CHEIRYL PACTANAC (DDS)
Entity type:Individual
Prefix:DR
First Name:CHEIRYL
Middle Name:PACTANAC
Last Name:LEGASPI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2607 BRIDGEPORT WAY W STE 1K
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:98466-4725
Mailing Address - Country:US
Mailing Address - Phone:253-267-2648
Mailing Address - Fax:253-617-0729
Practice Address - Street 1:2607 BRIDGEPORT WAY W STE 1K
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PLACE
Practice Address - State:WA
Practice Address - Zip Code:98466-4725
Practice Address - Country:US
Practice Address - Phone:253-777-2531
Practice Address - Fax:253-533-7214
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-06
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60850116122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist