MEDICARE: DR. FALAMACK ZALTASH DDS

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
1	1223G0001X	General Practice Dentistry	40769	CA

General Provider Information

NPI Number	:	1548316862
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FALAMACK ZALTASH DDS

Provider Business Mailing Address
First Line	:	410 S GLENDORA AVE STE 150
Second Line	:
City	:	GLENDORA
State	:	CA
Zip	:	91741-6207
Country	:	US
Telephone Number	:	626-967-6767
Fax Number	:	626-966-2986

Provider Business Practice Location Address
First Line	:	410 S GLENDORA AVE STE 150
Second Line	:
City	:	GLENDORA
State	:	CA
Zip	:	91741-6207
Country	:	US
Telephone Number	:	626-945-4545
Fax Number	:	626-966-2986

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/27/2007
Last Update Date	:	05/03/2023

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