Provider Demographics
NPI:1700944311
Name:GALIDA, EDWARD MATTHEW (DDS)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:MATTHEW
Last Name:GALIDA
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 1:741 MILL RD
Mailing Address - Street 2:
Mailing Address - City:BELLVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44813-1280
Mailing Address - Country:US
Mailing Address - Phone:419-886-0200
Mailing Address - Fax:410-886-4495
Practice Address - Street 1:741 MILL RD
Practice Address - Street 2:
Practice Address - City:BELLVILLE
Practice Address - State:OH
Practice Address - Zip Code:44813-1280
Practice Address - Country:US
Practice Address - Phone:419-886-0200
Practice Address - Fax:410-886-4495
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300214231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1513327OtherID FOR UNITED CONCORDIA