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Individual

DR. ANTONIO GALES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
1823 SOMERVILLE RD SE, DECATUR, AL 35601-5015
(256) 355-2275
Mailing address
1823 SOMERVILLE RD SE, DECATUR, AL 35601-5015
(256) 355-2275

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4897
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009906070
AL
01
1347699
UNITED CONCORDIA
AL
01
51500214
BCBS OF AL
AL
01
631069848
TAX ID
AL
Enumeration date
08/08/2006
Last updated
07/09/2007
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