Provider Demographics
NPI:1609098862
Name:GALLAGHER, GREGORY PETER (DDS)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:PETER
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 1:6764 INNSBRUCK DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45459-1257
Mailing Address - Country:US
Mailing Address - Phone:937-435-1298
Mailing Address - Fax:
Practice Address - Street 1:6764 INNSBRUCK DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45459-1257
Practice Address - Country:US
Practice Address - Phone:937-435-1298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300143621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice