Provider Demographics
NPI:1275795163
Name:DELL'ACQUA, RENE YVONNE (DDS)
Entity Type:Individual
Prefix:DR
First Name:RENE
Middle Name:YVONNE
Last Name:DELL'ACQUA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74133 EL PASEO
Mailing Address - Street 2:SUITE D
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92260-4119
Mailing Address - Country:US
Mailing Address - Phone:760-346-8056
Mailing Address - Fax:760-773-9978
Practice Address - Street 1:74133 EL PASEO
Practice Address - Street 2:SUITE D
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-4119
Practice Address - Country:US
Practice Address - Phone:760-346-8056
Practice Address - Fax:760-773-9978
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-01
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43777122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist