Provider Demographics
NPI:1477846632
Name:GALLOWAY, PATRICK BRANNON (DDS)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:BRANNON
Last Name:GALLOWAY
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 1:1666 SNOWMASS WAY
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-4513
Mailing Address - Country:US
Mailing Address - Phone:919-454-3144
Mailing Address - Fax:
Practice Address - Street 1:1666 SNOWMASS WAY
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-4513
Practice Address - Country:US
Practice Address - Phone:919-454-3144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-20
Last Update Date:2011-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9111122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist