Provider Demographics
NPI:1336249424
Name:ARCENEAUX, LEONCE M (DDS)
Entity Type:Individual
Prefix:
First Name:LEONCE
Middle Name:M
Last Name:ARCENEAUX
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 N GILBERT ST
Mailing Address - Street 2:BULILDING B
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92543-4066
Mailing Address - Country:US
Mailing Address - Phone:951-929-0414
Mailing Address - Fax:951-652-2049
Practice Address - Street 1:255 N GILBERT ST
Practice Address - Street 2:BULILDING B
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543-4066
Practice Address - Country:US
Practice Address - Phone:951-929-0414
Practice Address - Fax:951-652-2049
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA263321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA26332OtherSTATE LICENSE NUMBER