# JESUS CARLOS GALVAN, D.D.S., PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285647149
- **Authorized official:** DR. JESUS CARLOS GALVAN DDS (PRESIDENT)
- **Authorized official phone:** (505) 855-7103

## Contact information

- **Practice address:** 2500 LOUISIANA BLVD NE STE 600, ALBUQUERQUE, NM 87110-4372
- **Practice address phone:** (505) 855-7103
- **Practice address fax:** (505) 883-7444
- **Mailing address:** 2500 LOUISIANA BLVD NE STE 600, ALBUQUERQUE, NM 87110-4372
- **Mailing address phone:** (505) 855-7103
- **Mailing address fax:** (505) 883-7444

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 1463 | NM | Yes |

## Other

- **Enumeration date:** 08/14/2006
- **Last updated:** 08/22/2020