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Organization
ELGENDI DENTAL CORPORATION
Active
Organization
ELGENDI DENTAL CORPORATION
Active
Other names
Hacienda Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LUPE GOMEZ (OFFICE MANAGER)
(626) 336-2878
Entity
Organization
Contact information
Practice address
818 N HACIENDA BLVD STE J, LA PUENTE, CA 91744-2806
(626) 336-2878
(626) 336-2879
Mailing address
818 N HACIENDA BLVD STE J, LA PUENTE, CA 91744-2806
(626) 336-2878
(626) 336-2879
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
05/19/2021
Last updated
02/01/2022
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