Organization
ELENES DENTAL CORPORATION
Active
Other names
Legacy Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL ELENES D.D.S. (PRESIDENT)
(310) 637-2600
Entity
Organization
Contact information
Practice address
11330 LONG BEACH BLVD, SUITE 100, LYNWOOD, CA 90262-3340
(310) 637-2600
(310) 637-2638
Mailing address
11330 LONG BEACH BLVD, SUITE 100, LYNWOOD, CA 90262-3340
(310) 637-2600
(310) 637-2638
Taxonomy
Speciality
Code
Description
License number
State
292200000X
Dental Laboratory
Primary
30715
CA
Other
Enumeration date
03/24/2011
Last updated
03/24/2011
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