Provider Demographics
NPI:1417092701
Name:DRS. GALITSIS AND BOVINO
Entity Type:Organization
Organization Name:DRS. GALITSIS AND BOVINO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:GALITSIS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:201-664-0367
Mailing Address - Street 1:345 KINDERKAMACK RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:WESTWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-1600
Mailing Address - Country:US
Mailing Address - Phone:201-664-0367
Mailing Address - Fax:201-664-2334
Practice Address - Street 1:345 KINDERKAMACK RD
Practice Address - Street 2:SUITE D
Practice Address - City:WESTWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07675-1600
Practice Address - Country:US
Practice Address - Phone:201-664-0367
Practice Address - Fax:201-664-2334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ157821223P0700X
NJ166121223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered1223P0700XDental ProvidersDentistProsthodonticsGroup - Multi-Specialty
Not Answered1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty