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NPI Code Detail

MEDICARE: GALVAN DENTAL LLC

MEDICARE: GALVAN DENTAL LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry47894CA

General Provider Information

NPI Number : 1174765911
Entity Type Code : Organization
Provider Name (Legal Business Name) : GALVAN DENTAL LLC
Provider Business Mailing Address
First Line : 2809 REDWOOD PKWY
Second Line :
City : VALLEJO
State : CA
Zip : 94591-3634
Country : US
Telephone Number : 707-643-2273
Fax Number : 707-643-4210
Provider Business Practice Location Address
First Line : 2809 REDWOOD PKWY
Second Line :
City : VALLEJO
State : CA
Zip : 94591-3634
Country : US
Telephone Number : 707-643-2273
Fax Number : 707-643-4210
Authorized Official
Title or Position : PRESIDENT
Name : DR. FELIPE HALILI GALVAN JR.
Credential : DDS
Telephone Number : 707-643-2273
Provider Enumeration Date : 03/25/2009
Last Update Date : 03/25/2009

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Directions to “GALVAN DENTAL LLC ” Practice Location

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