# ACEVEDO DENTAL OFFICE, INC.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ACEVEDO DENTAL OFFICE INC.
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1790201762
- **Legal business name:** ACEVEDO DENTAL OFFICE INC.
- **Authorized official:** LIDYA SORAYA ACEVEDO D.D.S (OWNER)
- **Authorized official phone:** (323) 724-1010

## Contact information

- **Practice address:** 2800 N MAIN ST UNIT 1010, SANTA ANA, CA 92705-6608
- **Practice address phone:** (714) 617-7979
- **Practice address fax:** (714) 617-7278
- **Mailing address:** 2800 N MAIN ST UNIT 1010, SANTA ANA, CA 92705-6608
- **Mailing address phone:** (714) 617-7979
- **Mailing address fax:** (714) 617-7278

## Taxonomy

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

## Other

- **Enumeration date:** 08/21/2017
- **Last updated:** 08/21/2017