Healthcare Provider Details

I. General information

NPI: 1447340807
Provider Name (Legal Business Name): RONALD DALE MCCALL D.D.S.,P.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 ASHLEMAN
WACO TX
76705
US

IV. Provider business mailing address

4000 BELMEAD DR.
WACO TX
76705
US

V. Phone/Fax

Practice location:
  • Phone: 254-799-5461
  • Fax: 254-799-1228
Mailing address:
  • Phone: 254-799-5461
  • Fax: 254-799-1228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberTEX13656
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: