Healthcare Provider Details

I. General information

NPI: 1982504601
Provider Name (Legal Business Name): FRANCISCO SERGIO GALVEZ SEVILLA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2026
Last Update Date: 11/06/2026
Certification Date: 11/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVE ADOLFO LOPEZ MATEOS 171 LOCAL 7
NOGALES SONORA
84000
MX

IV. Provider business mailing address

980 VIA PUEBLA
RIO RICO AZ
85648-1918
US

V. Phone/Fax

Practice location:
  • Phone:
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. FRANCISCO SERGIO GALVEZ SEVILLA
Title or Position: DENTIST
Credential: DDS
Phone: 631-113-9966