Organization
GALLERIA ORAL AND MAXILLOFACIAL SURGERY
Active
Other names
Alexander O. Antipov, D.D.S., Inc
Organization subpart
No
Provider details
NPI number
Authorized official
YELENA MYALIK (OFFICE MANAGER)
(916) 783-2110
Entity
Organization
Contact information
Practice address
911 RESERVE DRIVE, SUITE #150, ROSEVILLE, CA 95678
(916) 783-2110
(916) 783-2111
Mailing address
911 RESERVE DRIVE, SUITE #150, ROSEVILLE, CA 95678
(916) 783-2110
(916) 783-2111
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
CA
Other
Enumeration date
01/30/2014
Last updated
01/30/2014
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