Provider Demographics
NPI:1336292366
Name:GALARZA ESCOBAR, LUIS S (DMD)
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:S
Last Name:GALARZA ESCOBAR
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 AVE SAN LUIS
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612-3640
Mailing Address - Country:US
Mailing Address - Phone:787-878-4102
Mailing Address - Fax:787-878-4107
Practice Address - Street 1:560 AVE SAN LUIS
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-3640
Practice Address - Country:US
Practice Address - Phone:787-878-4102
Practice Address - Fax:787-878-4107
Is Sole Proprietor?:No
Enumeration Date:2007-01-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR19991223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery