Provider Demographics
NPI:1922208602
Name:MARIA ELENA ACAL D.M.D. A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:MARIA ELENA ACAL D.M.D. A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:ELENA
Authorized Official - Last Name:ACAL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:951-493-6600
Mailing Address - Street 1:1530 W 6TH ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-2742
Mailing Address - Country:US
Mailing Address - Phone:951-493-6600
Mailing Address - Fax:951-493-6777
Practice Address - Street 1:1530 W 6TH ST
Practice Address - Street 2:SUITE 105
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-2742
Practice Address - Country:US
Practice Address - Phone:951-493-6600
Practice Address - Fax:951-493-6777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-20
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty