Provider Demographics
NPI:1417091927
Name:MARIA AMPARO ROMANO, DDS, INC
Entity Type:Organization
Organization Name:MARIA AMPARO ROMANO, DDS, INC
Other - Org Name:GALLERIA DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:AMPARO
Authorized Official - Last Name:ROMANO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:310-370-1586
Mailing Address - Street 1:2772 ARTESIA BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90278-3370
Mailing Address - Country:US
Mailing Address - Phone:310-370-1586
Mailing Address - Fax:310-370-1588
Practice Address - Street 1:2772 ARTESIA BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90278-3370
Practice Address - Country:US
Practice Address - Phone:310-370-1586
Practice Address - Fax:310-370-1588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2014-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA364221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty