Provider Demographics
NPI:1275553406
Name:GALLEGOS, ROBERT ALAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ALAN
Last Name:GALLEGOS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 386
Mailing Address - Street 2:204 E FEDERAL ST
Mailing Address - City:MIDDLEBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20118-0386
Mailing Address - Country:US
Mailing Address - Phone:540-687-6363
Mailing Address - Fax:540-687-6733
Practice Address - Street 1:204 E FEDERAL ST,
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG
Practice Address - State:VA
Practice Address - Zip Code:20118-0386
Practice Address - Country:US
Practice Address - Phone:540-687-6363
Practice Address - Fax:540-687-6733
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA63921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice