Provider Demographics
NPI:1578908471
Name:GALOW, TIMOTHY LEE (DDS)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:LEE
Last Name:GALOW
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 1:225 N RICHMOND ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54911-4601
Mailing Address - Country:US
Mailing Address - Phone:920-731-6545
Mailing Address - Fax:
Practice Address - Street 1:225 N RICHMOND ST
Practice Address - Street 2:SUITE 202
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54911-4601
Practice Address - Country:US
Practice Address - Phone:920-731-6545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-06
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5001315WI122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1134277692OtherORGANIZATIONAL NPI