Provider Demographics
NPI:1932127156
Name:GALLIA, LOUIS (DMD, MD)
Entity Type:Individual
Prefix:
First Name:LOUIS
Middle Name:
Last Name:GALLIA
Suffix:
Gender:M
Credentials:DMD, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:87 SCRIPPS DR
Mailing Address - Street 2:SUITE 112
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-6372
Mailing Address - Country:US
Mailing Address - Phone:916-570-3088
Mailing Address - Fax:916-570-3089
Practice Address - Street 1:87 SCRIPPS DR
Practice Address - Street 2:SUITE 112
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-6372
Practice Address - Country:US
Practice Address - Phone:916-570-3088
Practice Address - Fax:916-570-3089
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2015-02-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAOMS451223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery