# ALEX GLADKOV A PROFESSIONAL DENTAL CORPORATION

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

## Provider details

- **NPI number:** 1831414119
- **Authorized official:** ALEXANDER GREGORY GLADKOV DDS (OWNER)
- **Authorized official phone:** (714) 953-6881

## Contact information

- **Practice address:** 1920 E 17TH ST, SUITE 100, SANTA ANA, CA 92705-8626
- **Practice address phone:** (714) 953-6881
- **Practice address fax:** (714) 558-8618
- **Mailing address:** 1920 E 17TH ST, SUITE 100, SANTA ANA, CA 92705-8626
- **Mailing address phone:** (714) 953-6881
- **Mailing address fax:** (714) 558-8618

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 40822 | CA | Yes |

## Other

- **Enumeration date:** 03/30/2010
- **Last updated:** 03/30/2010