Provider Demographics
NPI:1891802864
Name:TENA DENTAL CORPORATION
Entity Type:Organization
Organization Name:TENA DENTAL CORPORATION
Other - Org Name:SMILE CHOICE DENTAL PRACTICE OF DR ERNESTO M TENA DDA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERNESTO
Authorized Official - Middle Name:M
Authorized Official - Last Name:TENA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:626-962-8160
Mailing Address - Street 1:607 E ARROW HWY
Mailing Address - Street 2:
Mailing Address - City:AZUSA
Mailing Address - State:CA
Mailing Address - Zip Code:91702
Mailing Address - Country:US
Mailing Address - Phone:626-915-3616
Mailing Address - Fax:626-915-3045
Practice Address - Street 1:14323 E RAMONA BLVD
Practice Address - Street 2:
Practice Address - City:BALDWIN PARK
Practice Address - State:CA
Practice Address - Zip Code:91706-3242
Practice Address - Country:US
Practice Address - Phone:626-962-8160
Practice Address - Fax:626-962-8170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA483891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty