Provider Demographics
NPI:1457897332
Name:MARIA THERESE GALANG DMD MS P C
Entity Type:Organization
Organization Name:MARIA THERESE GALANG DMD MS P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARIA THERESE
Authorized Official - Middle Name:
Authorized Official - Last Name:GALANG
Authorized Official - Suffix:
Authorized Official - Credentials:DMD MS
Authorized Official - Phone:312-450-2434
Mailing Address - Street 1:222 E PEARSON ST
Mailing Address - Street 2:#1402
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-7347
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:30 N MICHIGAN AVE STE 622
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-3821
Practice Address - Country:US
Practice Address - Phone:773-609-4446
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-16
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019027449332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment