Provider Demographics
NPI:1518047836
Name:GALLAGHER, ROBERT WAYNE (DDS; MS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:WAYNE
Last Name:GALLAGHER
Suffix:
Gender:M
Credentials:DDS; MS
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Mailing Address - Street 1:4900 BEE CREEK
Mailing Address - Street 2:#201
Mailing Address - City:SPICEWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:78669
Mailing Address - Country:US
Mailing Address - Phone:512-379-8222
Mailing Address - Fax:512-359-5851
Practice Address - Street 1:4900 BEE CREEK
Practice Address - Street 2:#201
Practice Address - City:SPICEWOOD
Practice Address - State:TX
Practice Address - Zip Code:78669
Practice Address - Country:US
Practice Address - Phone:512-379-8222
Practice Address - Fax:512-359-5851
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2022-02-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX161861223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics