Provider Demographics
NPI:1699955070
Name:JOSEPH D. GALLEMORE DDS & ASSOCIATES P.C.
Entity type:Organization
Organization Name:JOSEPH D. GALLEMORE DDS & ASSOCIATES P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-782-4707
Mailing Address - Street 1:2179 W 24TH ST.
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364
Mailing Address - Country:US
Mailing Address - Phone:928-782-4707
Mailing Address - Fax:928-569-0964
Practice Address - Street 1:1946 E JUAN SANCHEZ BLVD STE 5
Practice Address - Street 2:
Practice Address - City:SAN LUIS
Practice Address - State:AZ
Practice Address - Zip Code:85336-0478
Practice Address - Country:US
Practice Address - Phone:928-627-5977
Practice Address - Fax:928-569-0964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-14
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty