Provider Demographics
NPI:1265530554
Name:GALAN, AIDA MARCELA (DMD)
Entity type:Individual
Prefix:DR
First Name:AIDA
Middle Name:MARCELA
Last Name:GALAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 24586
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95154-4586
Mailing Address - Country:US
Mailing Address - Phone:408-377-8200
Mailing Address - Fax:408-377-8206
Practice Address - Street 1:1706 HAMILTON AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95125-5424
Practice Address - Country:US
Practice Address - Phone:408-377-8200
Practice Address - Fax:408-377-8206
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA502571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice