Provider Demographics
NPI:1417020868
Name:GALLAGHER VENTURES
Entity Type:Organization
Organization Name:GALLAGHER VENTURES
Other - Org Name:DENTAL WORLD OF ARIZONA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:GALLAGHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-997-5096
Mailing Address - Street 1:6605 N 19TH AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85015-1628
Mailing Address - Country:US
Mailing Address - Phone:602-997-5096
Mailing Address - Fax:602-944-4380
Practice Address - Street 1:6605 N 19TH AVE
Practice Address - Street 2:SUITE D
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015-1628
Practice Address - Country:US
Practice Address - Phone:602-997-5096
Practice Address - Fax:602-944-4380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty