Provider Demographics
NPI:1972533164
Name:GALLERY, DAVID F (DMD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:F
Last Name:GALLERY
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 1:526 ADAMS ST
Mailing Address - Street 2:P.O. BOX 464
Mailing Address - City:MILTON
Mailing Address - State:MA
Mailing Address - Zip Code:02186-5628
Mailing Address - Country:US
Mailing Address - Phone:617-698-0150
Mailing Address - Fax:617-696-7775
Practice Address - Street 1:526 ADAMS ST
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:MA
Practice Address - Zip Code:02186-5628
Practice Address - Country:US
Practice Address - Phone:617-698-0150
Practice Address - Fax:617-696-7775
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA101931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice