Provider Demographics
NPI:1396034401
Name:GALLEGO, ANA MARIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANA
Middle Name:MARIA
Last Name:GALLEGO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16199 SADDLE CLUB RD # 101
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-1731
Mailing Address - Country:US
Mailing Address - Phone:954-588-8381
Mailing Address - Fax:
Practice Address - Street 1:16199 SADDLE CLUB RD # 101
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-1731
Practice Address - Country:US
Practice Address - Phone:954-588-8381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-30
Last Update Date:2011-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN187181223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry