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General NPI Number Information
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NPI Number | 1922251727
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Entity Type | Individual
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Provider Name | MIRTHA GIANNINA GALLIANI ALVAREZ D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 10/24/2008
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Last Update Date | 10/24/2008
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Provider Practice Location Address
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Address Line | 3460 OLD WASHINGTON RD STE 200
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City | WALDORF
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State | MD
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Zip | 20602-3242
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Country | US
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Telephone | 301-645-6556
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Fax | 301-638-3131
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Provider Business Mailing Address
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Address Line | 3000 WASHINGTON BLVD APT 713
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City | ARLINGTON
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State | VA
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Zip | 22201-2153
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Country | US
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Telephone | 410-456-4584
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Fax | 301-368-3131
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 14224
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License Number State | MD
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