Provider Demographics
NPI:1780739086
Name:SYLVIE M GALERNEAU, DMD
Entity type:Organization
Organization Name:SYLVIE M GALERNEAU, DMD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:SYLVIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GALERNEAU
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:650-342-9941
Mailing Address - Street 1:100 S ELLSWORTH AVE
Mailing Address - Street 2:SUITE 601
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94401-3939
Mailing Address - Country:US
Mailing Address - Phone:650-342-9941
Mailing Address - Fax:650-342-9545
Practice Address - Street 1:100 S ELLSWORTH AVE
Practice Address - Street 2:SUITE 601
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94401-3939
Practice Address - Country:US
Practice Address - Phone:650-342-9941
Practice Address - Fax:650-342-9545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33766122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA100276OtherUNITED CONCORDIA