Provider Demographics
NPI:1962546606
Name:DEALCA, LOVEGEL MAYOR (DDS)
Entity type:Individual
Prefix:DR
First Name:LOVEGEL
Middle Name:MAYOR
Last Name:DEALCA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1238 E CHAMPLAIN DR
Mailing Address - Street 2:APT 208
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-5069
Mailing Address - Country:US
Mailing Address - Phone:702-480-9155
Mailing Address - Fax:
Practice Address - Street 1:2670 S JONES BLVD
Practice Address - Street 2:STE 1
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-5341
Practice Address - Country:US
Practice Address - Phone:702-880-9527
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA554611223G0001X
NV54941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice