Provider Demographics
NPI:1710029095
Name:CALALANG, PATRICK LOUIE (DMD)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:LOUIE
Last Name:CALALANG
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2450 E GUADALUPE
Mailing Address - Street 2:# 108
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234
Mailing Address - Country:US
Mailing Address - Phone:480-632-9600
Mailing Address - Fax:480-633-3446
Practice Address - Street 1:2450 E GUADALUPE
Practice Address - Street 2:# 108
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234
Practice Address - Country:US
Practice Address - Phone:480-632-9600
Practice Address - Fax:480-633-3446
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4863122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist