# GC PERIODONTICS LLC

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

## Provider details

- **NPI number:** 1376361824
- **Authorized official:** GABRIELLA CORDERO GALLARDO DMD (PRESIDENT)
- **Authorized official phone:** (787) 422-6861

## Contact information

- **Practice address:** INSTITUTO SAN PABLO, CALLE SANTA CRUZ \#66 SUITE 103, BAYAMON, PR 00961
- **Practice address phone:** (787) 925-1665
- **Mailing address:** 1511 AVE PONCE DE LEON, TORRE 900 APT. 994, SAN JUAN, PR 00909
- **Mailing address phone:** (787) 371-0209

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0300X | Periodontics | — | NULL | Yes |
| 1223P0300X | Periodontics | — | — | Yes |

## Other

- **Enumeration date:** 10/02/2024
- **Last updated:** 10/02/2024