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Organization
TENA DENTAL CORPORATION
Active
Organization
TENA DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ERNERSTO M TENA DDS (OWNER)
(626) 810-0045
Entity
Organization
Contact information
Practice address
525 S AZUSA WAY, LA PUENTE, CA 91744-5113
(626) 810-0045
Mailing address
525 S AZUSA WAY, LA PUENTE, CA 91744-5113
(626) 810-0045
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
48389
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G93496-02
DENTICAL
CA
Enumeration date
12/27/2007
Last updated
12/27/2007
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