Provider Demographics
NPI:1255350617
Name:GALATAS, DAVID EDWARD (DDS)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:EDWARD
Last Name:GALATAS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:618 N BOYLAN AVE STE 730
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27603-1439
Mailing Address - Country:US
Mailing Address - Phone:919-247-1399
Mailing Address - Fax:
Practice Address - Street 1:560 DABNEY DR STE C
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536-3946
Practice Address - Country:US
Practice Address - Phone:252-438-7384
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7930122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5901507Medicaid
NC9023FOtherBCBS OF NC