Provider Demographics
NPI:1437686839
Name:GALLAGHER, AIDAN SEAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:AIDAN
Middle Name:SEAN
Last Name:GALLAGHER
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 1:18 CAMPUS BLVD., SUITE 100
Mailing Address - Street 2:OFFICE 115
Mailing Address - City:NEWTOWN SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19073
Mailing Address - Country:US
Mailing Address - Phone:484-319-6496
Mailing Address - Fax:
Practice Address - Street 1:220 CUMBERLAND PKWY STE 6
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17055-5683
Practice Address - Country:US
Practice Address - Phone:732-986-3690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-16
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI029370001223D0004X
390200000X
PADS0434451223D0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0004XDental ProvidersDentistDentist Anesthesiologist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program