Provider Demographics
NPI:1073633707
Name:GALLA, STEPHEN THOMAS (DMD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:THOMAS
Last Name:GALLA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11211 PROSPERITY FARMS RD
Mailing Address - Street 2:SUITE B107
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-3446
Mailing Address - Country:US
Mailing Address - Phone:561-630-8900
Mailing Address - Fax:561-630-8909
Practice Address - Street 1:11211 PROSPERITY FARMS RD
Practice Address - Street 2:SUITE B107
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-3446
Practice Address - Country:US
Practice Address - Phone:561-630-8900
Practice Address - Fax:561-630-8909
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLDN165491223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics