Provider Demographics
NPI:1528030608
Name:GAROFALIS, HARALAMBOS BOBBY (DDS)
Entity Type:Individual
Prefix:DR
First Name:HARALAMBOS
Middle Name:BOBBY
Last Name:GAROFALIS
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 1:220 NAT TURNER BLVD. S
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606
Mailing Address - Country:US
Mailing Address - Phone:757-240-5711
Mailing Address - Fax:757-240-4939
Practice Address - Street 1:220 NAT TURNER BLVD. S
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606
Practice Address - Country:US
Practice Address - Phone:757-240-5711
Practice Address - Fax:757-240-4939
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014109121223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA009177642Medicaid