MEDICARE: JOSEPH D. GALLEMORE DDS & ASSOCIATES P.C.

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

General Provider Information

NPI Number	:	1699955070
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOSEPH D. GALLEMORE DDS & ASSOCIATES P.C.

Provider Business Mailing Address
First Line	:	2179 W 24TH ST.
Second Line	:
City	:	YUMA
State	:	AZ
Zip	:	85364
Country	:	US
Telephone Number	:	928-782-4707
Fax Number	:	928-569-0964

Provider Business Practice Location Address
First Line	:	1946 E JUAN SANCHEZ BLVD STE 5
Second Line	:
City	:	SAN LUIS
State	:	AZ
Zip	:	85336-0478
Country	:	US
Telephone Number	:	928-627-5977
Fax Number	:	928-569-0964

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MR. JOSE CASTRO
Credential	:
Telephone Number	:	928-782-4707

Provider Enumeration Date	:	11/14/2007
Last Update Date	:	10/28/2020

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