Provider Demographics
NPI:1790942340
Name:GALVAN, FELIPE HALILI JR (DDS)
Entity Type:Individual
Prefix:
First Name:FELIPE
Middle Name:HALILI
Last Name:GALVAN
Suffix:JR
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 1:3906 DECOTO RD
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94555-3114
Mailing Address - Country:US
Mailing Address - Phone:510-818-9648
Mailing Address - Fax:510-818-9748
Practice Address - Street 1:3906 DECOTO RD
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94555-3114
Practice Address - Country:US
Practice Address - Phone:510-818-9648
Practice Address - Fax:510-818-9748
Is Sole Proprietor?:No
Enumeration Date:2008-05-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA478941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice