Provider Demographics
NPI:1104286830
Name:EMMA GALVAN & ASSOCIATES DDS PC
Entity type:Organization
Organization Name:EMMA GALVAN & ASSOCIATES DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EMMA
Authorized Official - Middle Name:
Authorized Official - Last Name:GALVAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-332-4889
Mailing Address - Street 1:20 E TIMONIUM RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:TIMONIUM
Mailing Address - State:MD
Mailing Address - Zip Code:21093-3400
Mailing Address - Country:US
Mailing Address - Phone:410-252-3717
Mailing Address - Fax:
Practice Address - Street 1:20 E TIMONIUM RD
Practice Address - Street 2:SUITE 300
Practice Address - City:TIMONIUM
Practice Address - State:MD
Practice Address - Zip Code:21093-3400
Practice Address - Country:US
Practice Address - Phone:410-252-3717
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-23
Last Update Date:2016-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty