Individual
CHRISTOPHER JUFFAN GALEOS PORQUIADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRDH
Contact information
Practice address
BLDG 460 OSBORNE DENTAL CLINIC, 2ND DENTAL BATTALION, CAMP LEJEUNE, NC 28542-0125
(910) 467-3930
Mailing address
PSC BOX 20130, CAMP LEJEUNE, NC 28542-0125
(910) 467-3930
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH26009
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y6208144
TRICARE
CA
Enumeration date
11/01/2021
Last updated
11/01/2021
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