Provider Demographics
NPI:1710475470
Name:GALLAGHER, ERIN LORENE (RDH)
Entity Type:Individual
Prefix:MS
First Name:ERIN
Middle Name:LORENE
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 RAMSGATE SQ S STE 120
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-5873
Mailing Address - Country:US
Mailing Address - Phone:503-363-1661
Mailing Address - Fax:
Practice Address - Street 1:140 RAMSGATE SQ S STE 120
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-5873
Practice Address - Country:US
Practice Address - Phone:503-363-1661
Practice Address - Fax:503-362-5092
Is Sole Proprietor?:No
Enumeration Date:2018-04-27
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORH5846124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist