Provider Demographics
NPI:1437451648
Name:MARCELA G BUENDIA DDS INC A DENTAL CORPORATION
Entity Type:Organization
Organization Name:MARCELA G BUENDIA DDS INC A DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCELA
Authorized Official - Middle Name:GIRALDO
Authorized Official - Last Name:BUENDIA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-736-0128
Mailing Address - Street 1:2521 E FLORENCE AVE STE B2
Mailing Address - Street 2:CA
Mailing Address - City:HUNTINGTON PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90255-7600
Mailing Address - Country:US
Mailing Address - Phone:323-582-4600
Mailing Address - Fax:
Practice Address - Street 1:2521 E FLORENCE AVE STE B2
Practice Address - Street 2:CA
Practice Address - City:HUNTINGTON PARK
Practice Address - State:CA
Practice Address - Zip Code:90255-7600
Practice Address - Country:US
Practice Address - Phone:323-582-4600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-19
Last Update Date:2010-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA56579122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty