Provider Demographics
NPI:1851477889
Name:GAROFALO, WILLIAM RALPH (DMD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:RALPH
Last Name:GAROFALO
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 1:399 LIBERTY ST.
Mailing Address - Street 2:
Mailing Address - City:PERRYOPOLIS
Mailing Address - State:PA
Mailing Address - Zip Code:15473-0636
Mailing Address - Country:US
Mailing Address - Phone:724-736-2550
Mailing Address - Fax:724-785-2184
Practice Address - Street 1:399 LIBERTY ST.
Practice Address - Street 2:
Practice Address - City:PERRYOPOLIS
Practice Address - State:PA
Practice Address - Zip Code:15473
Practice Address - Country:US
Practice Address - Phone:724-736-2550
Practice Address - Fax:724-785-2184
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-024140-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice