Provider Demographics
NPI:1225166796
Name:GALLINGER, JAMES MARTIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:MARTIN
Last Name:GALLINGER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 N KIRKWOOD RD
Mailing Address - Street 2:SUITE101
Mailing Address - City:KIRKWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63122-4042
Mailing Address - Country:US
Mailing Address - Phone:314-965-4624
Mailing Address - Fax:
Practice Address - Street 1:325 N KIRKWOOD RD
Practice Address - Street 2:SUITE101
Practice Address - City:KIRKWOOD
Practice Address - State:MO
Practice Address - Zip Code:63122-4042
Practice Address - Country:US
Practice Address - Phone:314-965-4624
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0137361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice