Grand Legacy Dental
Grand Legacy Dental provides General Practice Dentistry in San Diego, California. Registered with an NPI since 2025.
- In the registry since
- 2025
Practice location Address checks out
2654 4th AveSan Diego, CA 92103-6515
Phone: (619) 234-7493
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| General Practice Dentistry (primary) | Taxonomy 1223G0001X |
|---|
Record details
| NPI number | 1932079878 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | Yes |
| Parent organization | Evan Demko DDS Inc |
| Authorized official | Evan Demko — Dentist · (619) 234-7493 |
| NPI enumerated | November 6, 2025 |
| Last updated in NPPES | November 6, 2025 |
| Certification date | November 6, 2025 |
| Mailing address | 2654 4th Ave, San Diego, CA 92103-6515 |
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