Provider Demographics
NPI:1811177769
Name:GALARZA, MARIA ISABEL (DDS)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:ISABEL
Last Name:GALARZA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 B FERRY ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07105-3218
Mailing Address - Country:US
Mailing Address - Phone:973-817-8200
Mailing Address - Fax:973-817-7730
Practice Address - Street 1:241 B FERRY ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07105-3218
Practice Address - Country:US
Practice Address - Phone:973-817-8200
Practice Address - Fax:973-817-7730
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-08
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI20891261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0007771140OtherAETNA
NJ00002891OtherDELTA