Organization
ALEX GLADKOV A PROFESSIONAL DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXANDER GREGORY GLADKOV DDS (OWNER)
(714) 953-6881
Entity
Organization
Contact information
Practice address
1920 E 17TH ST, SUITE 100, SANTA ANA, CA 92705-8626
(714) 953-6881
(714) 558-8618
Mailing address
1920 E 17TH ST, SUITE 100, SANTA ANA, CA 92705-8626
(714) 953-6881
(714) 558-8618
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
40822
CA
Other
Enumeration date
03/30/2010
Last updated
03/30/2010
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