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General NPI Number Information
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NPI Number | 1215141643
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Entity Type | Individual
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Provider Name | LOUISA ISABELLE GALLEGOS D.D.S.,M.S.D.
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Gender | Female
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 90 MADISON ST SUITE 208
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City | DENVER
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State | CO
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Zip | 80206-5418
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Country | US
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Telephone | 303-316-4034
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Fax | 303-316-0901
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Provider Business Mailing Address
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Address Line | 90 MADISON ST SUITE 208
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City | DENVER
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State | CO
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Zip | 80206-5418
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Country | US
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Telephone | 303-316-4034
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Fax | 303-316-0901
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 5465
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License Number State | CO
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