Provider Demographics
NPI:1801326806
Name:GALLELLI, JOSEPH PASQUALE (DMD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:PASQUALE
Last Name:GALLELLI
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 1:1307 WHITE HORSE RD STE 500
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-2161
Mailing Address - Country:US
Mailing Address - Phone:856-627-3400
Mailing Address - Fax:
Practice Address - Street 1:1307 WHITE HORSE RD STE 500
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-2161
Practice Address - Country:US
Practice Address - Phone:856-627-3400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-13
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI026772001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice