Provider Demographics
NPI:1558674085
Name:GALARRAGA, EMILIO OSCAR (DDS)
Entity Type:Individual
Prefix:DR
First Name:EMILIO
Middle Name:OSCAR
Last Name:GALARRAGA
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 1:2437 OLIVEWOOD ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89108-4408
Mailing Address - Country:US
Mailing Address - Phone:702-538-1825
Mailing Address - Fax:
Practice Address - Street 1:334 E LAKE ST
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55408-2407
Practice Address - Country:US
Practice Address - Phone:312-422-0838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-26
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLGL41223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice