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NPI Code Detail

MEDICARE: ALBERTO GALLASTEGUI D.D.S. INC.

MEDICARE: ALBERTO GALLASTEGUI D.D.S. INC.
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
1122300000XDentist

General Provider Information

NPI Number : 1659787331
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALBERTO GALLASTEGUI D.D.S. INC.
Provider Business Mailing Address
First Line : 1701 N MAIN ST
Second Line : SUITE 100
City : SANTA ANA
State : CA
Zip : 92706-2745
Country : US
Telephone Number : 714-554-0513
Fax Number : 714-554-9020
Provider Business Practice Location Address
First Line : 1701 N MAIN ST
Second Line : SUITE 100
City : SANTA ANA
State : CA
Zip : 92706-2745
Country : US
Telephone Number : 714-554-0513
Fax Number : 714-554-9020
Authorized Official
Title or Position : PRESIDENT/DENTIST
Name : DR. ALBERTO RAUL GALLASTEGUI
Credential : D.D.S.
Telephone Number : 714-554-0513
Provider Enumeration Date : 07/02/2014
Last Update Date : 07/03/2014

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Directions to “ALBERTO GALLASTEGUI D.D.S. INC. ” Practice Location

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