Provider Demographics
NPI:1548316862
Name:ZALTASH, FALAMACK (DDS)
Entity type:Individual
Prefix:DR
First Name:FALAMACK
Middle Name:
Last Name:ZALTASH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 S GLENDORA AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91741-6207
Mailing Address - Country:US
Mailing Address - Phone:626-967-6767
Mailing Address - Fax:626-966-2986
Practice Address - Street 1:410 S GLENDORA AVE STE 150
Practice Address - Street 2:
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91741-6207
Practice Address - Country:US
Practice Address - Phone:626-945-4545
Practice Address - Fax:626-966-2986
Is Sole Proprietor?:No
Enumeration Date:2007-01-27
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA407691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA954730916OtherTIN