Provider Demographics
NPI:1699820910
Name:GALLAGHER, WINAH B (DMD)
Entity Type:Individual
Prefix:
First Name:WINAH
Middle Name:B
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 LAWN AVE STE E1
Mailing Address - Street 2:
Mailing Address - City:SELLERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18960-1560
Mailing Address - Country:US
Mailing Address - Phone:215-453-6630
Mailing Address - Fax:215-453-6909
Practice Address - Street 1:920 LAWN AVE STE E1
Practice Address - Street 2:
Practice Address - City:SELLERSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18960-1560
Practice Address - Country:US
Practice Address - Phone:215-453-6630
Practice Address - Fax:215-453-6909
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS030007-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice