Provider Demographics
NPI:1841979705
Name:GALLOWAY, KALEIGH (DMD)
Entity type:Individual
Prefix:
First Name:KALEIGH
Middle Name:
Last Name:GALLOWAY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9287 YORKSHIP CT
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-7413
Mailing Address - Country:US
Mailing Address - Phone:574-606-0741
Mailing Address - Fax:
Practice Address - Street 1:4660 NATOMAS BLVD STE 140
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95835-2221
Practice Address - Country:US
Practice Address - Phone:916-419-0254
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA108976122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist