Provider Demographics
NPI:1407585854
Name:NOELLE R. GAILEY DDS PLLC
Entity Type:Organization
Organization Name:NOELLE R. GAILEY DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NOELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:GAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:248-625-1769
Mailing Address - Street 1:7650 DIXIE HWY STE 120
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48346-2078
Mailing Address - Country:US
Mailing Address - Phone:248-625-1769
Mailing Address - Fax:
Practice Address - Street 1:7650 DIXIE HWY STE 120
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:MI
Practice Address - Zip Code:48346-2078
Practice Address - Country:US
Practice Address - Phone:248-625-1769
Practice Address - Fax:248-625-2626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-09
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental