Provider Demographics
NPI:1861118788
Name:AYALA MARCELA DDS CORP
Entity type:Organization
Organization Name:AYALA MARCELA DDS CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCELA
Authorized Official - Middle Name:DOLORES
Authorized Official - Last Name:AYALA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-654-0994
Mailing Address - Street 1:11922 SEACREST DR STE B
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92840-1937
Mailing Address - Country:US
Mailing Address - Phone:657-251-9222
Mailing Address - Fax:657-251-9233
Practice Address - Street 1:11922 SEACREST DR STE B
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92840-1937
Practice Address - Country:US
Practice Address - Phone:657-251-9222
Practice Address - Fax:657-251-9233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-12
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental