| NPI | 1841596954 |
|---|---|
| Doing Business As | LEGACY DENTAL |
| Entity Type | Organization |
| Authorized Contact | DANIEL ELENES Owner 310-637-2600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: CA 30715) |
| Enumeration Date | 2011-02-07 |
| Last Update Date | 2011-03-01 |