Healthcare Provider Details

I. General information

NPI: 1508491747
Provider Name (Legal Business Name): WILLIAM E GALBRETH, DMD,PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2020
Last Update Date: 03/09/2020
Certification Date: 03/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4830 JUAN TABO BLVD NE STE H
ALBUQUERQUE NM
87111-2682
US

IV. Provider business mailing address

4830 JUAN TABO BLVD NE STE H
ALBUQUERQUE NM
87111-2682
US

V. Phone/Fax

Practice location:
  • Phone: 505-298-8103
  • Fax: 505-298-2363
Mailing address:
  • Phone: 505-298-8103
  • Fax: 505-298-2363

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: WILLAIM EDWAR GALBRETH
Title or Position: OWNER
Credential: DMD
Phone: 505-298-8103