MEDICARE: DR. CRISTINA ALLALA 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	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	32396	TX
2	1223G0001X	General Practice Dentistry	32396	TX

General Provider Information

NPI Number	:	1972051654
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CRISTINA ALLALA DDS

Provider Business Mailing Address
First Line	:	2707 COLE AVE
Second Line	:	APT 424
City	:	DALLAS
State	:	TX
Zip	:	75204-1006
Country	:	US
Telephone Number	:	956-407-9045
Fax Number	:

Provider Business Practice Location Address
First Line	:	2707 COLE AVE
Second Line	:	APT 424
City	:	DALLAS
State	:	TX
Zip	:	75204-1006
Country	:	US
Telephone Number	:	956-407-9045
Fax Number	:

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

Provider Enumeration Date	:	09/12/2016
Last Update Date	:	06/27/2024

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