# ACEVDO DENTAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073012332
- **Authorized official:** LIDYA SORAYA ACEVEDO D.D.S. (OWNER/DDS)
- **Authorized official phone:** (323) 724-1010

## Contact information

- **Practice address:** 709 W BEVERLY BLVD STE 201, MONTEBELLO, CA 90640-3600
- **Practice address phone:** (323) 724-1010
- **Practice address fax:** (323) 724-2203
- **Mailing address:** 709 W BEVERLY BLVD STE 201, MONTEBELLO, CA 90640-3600
- **Mailing address phone:** (323) 724-1010
- **Mailing address fax:** (323) 724-2203

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 55423 | CA | Yes |

## Other

- **Enumeration date:** 02/01/2018
- **Last updated:** 02/01/2018