Provider Demographics
NPI:1598789455
Name:GALLAGHER, ROBERT P (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:P
Last Name:GALLAGHER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:242 CROSS ST
Mailing Address - Street 2:
Mailing Address - City:NORWELL
Mailing Address - State:MA
Mailing Address - Zip Code:02061-1345
Mailing Address - Country:US
Mailing Address - Phone:781-659-7546
Mailing Address - Fax:
Practice Address - Street 1:8 JEWEL RD
Practice Address - Street 2:
Practice Address - City:HOLBROOK
Practice Address - State:MA
Practice Address - Zip Code:02343-1506
Practice Address - Country:US
Practice Address - Phone:781-767-4551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA13693122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist