=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841537164
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MICHAEL D SETO AND THOMAS S MCGALLIARD DDS INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/07/2013
-----------------------------------------------------
Last Update Date | 01/07/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 73151 FRED WARING DR
-----------------------------------------------------
City | PALM DESERT
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92260-2843
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 760-837-0222
-----------------------------------------------------
Fax | 760-837-0142
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 73151 FRED WARING DR
-----------------------------------------------------
City | PALM DESERT
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92260-2843
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 760-837-0222
-----------------------------------------------------
Fax | 760-837-0142
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. MICHAEL DUANE SETO
-----------------------------------------------------
Credential | DDS
-----------------------------------------------------
Telephone | 760-837-0222
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number | 36284
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------