MEDICARE: DR. WILLIAM SCOTT GALBRETH D.D.S.

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	DD3135	NM

General Provider Information

NPI Number	:	1932336989
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM SCOTT GALBRETH D.D.S.

Provider Business Mailing Address
First Line	:	4830 JUAN TABO BLVD NE STE H
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87111-2682
Country	:	US
Telephone Number	:	505-298-8103
Fax Number	:	505-298-2363

Provider Business Practice Location Address
First Line	:	4830 JUAN TABO BLVD NE STE H
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87111-2682
Country	:	US
Telephone Number	:	505-298-8103
Fax Number	:	505-298-2363

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

Provider Enumeration Date	:	06/17/2009
Last Update Date	:	06/17/2009

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