MEDICARE: DR. MARIA ELENA ABELLO D.M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	39363	CA

General Provider Information

NPI Number	:	1790728335
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIA ELENA ABELLO D.M.D.

Provider Business Mailing Address
First Line	:	6 JOURNEY
Second Line	:	SUITE 150
City	:	ALISO VIEJO
State	:	CA
Zip	:	92656-5317
Country	:	US
Telephone Number	:	949-448-0900
Fax Number	:	949-362-3904

Provider Business Practice Location Address
First Line	:	6 JOURNEY
Second Line	:	SUITE 150
City	:	ALISO VIEJO
State	:	CA
Zip	:	92656-5317
Country	:	US
Telephone Number	:	949-448-0900
Fax Number	:	949-362-3904

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2006
Last Update Date	:	07/08/2007

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