Organization
ELENES DENTAL CORPORATION
Active
Other names
Legacy Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL ELENES D.D.S. (OWNER)
(310) 637-2600
Entity
Organization
Contact information
Practice address
3127 BALDWIN PARK BLVD, SUITE D, BALDWIN PARK, CA 91706-4754
(626) 962-3500
(626) 962-3551
Mailing address
3127 BALDWIN PARK BLVD, SUITE D, BALDWIN PARK, CA 91706-4754
(626) 962-3500
(626) 962-3551
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
30715
CA
Other
Enumeration date
02/07/2011
Last updated
03/01/2011
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