Provider Demographics
NPI:1447340807
Name:MCCALL, RONALD DALE (DDS,PA)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:DALE
Last Name:MCCALL
Suffix:
Gender:M
Credentials:DDS,PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 BELMEAD DR.
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76705
Mailing Address - Country:US
Mailing Address - Phone:254-799-5461
Mailing Address - Fax:254-799-1228
Practice Address - Street 1:901 ASHLEMAN
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76705
Practice Address - Country:US
Practice Address - Phone:254-799-5461
Practice Address - Fax:254-799-1228
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTEX13656122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist