Provider Demographics
NPI:1699823823
Name:GALA, SMITA RUPESH (DDS)
Entity Type:Individual
Prefix:DR
First Name:SMITA
Middle Name:RUPESH
Last Name:GALA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:33585 BARDOLPH CIR
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94555-2046
Mailing Address - Country:US
Mailing Address - Phone:510-796-6472
Mailing Address - Fax:510-796-1698
Practice Address - Street 1:2191 MOWRY AVE
Practice Address - Street 2:SUITE 600B
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1725
Practice Address - Country:US
Practice Address - Phone:510-796-6472
Practice Address - Fax:510-796-1698
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA502561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice