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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