Provider Demographics
NPI:1710161138
Name:ARLENE M. ALCALA-SY DENTAL CORPORATION
Entity Type:Organization
Organization Name:ARLENE M. ALCALA-SY DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNWER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARLENE
Authorized Official - Middle Name:MANALANSANG
Authorized Official - Last Name:ALCALA-SY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-502-9700
Mailing Address - Street 1:615 E. COLORADO ST.
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91205-1709
Mailing Address - Country:US
Mailing Address - Phone:818-502-9700
Mailing Address - Fax:
Practice Address - Street 1:615 E COLORADO ST
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205-1709
Practice Address - Country:US
Practice Address - Phone:818-502-9700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-20
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA504321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA50432OtherDENTAL BOARD OF CALIFORNI