Provider Demographics
NPI:1952771172
Name:ROBERT J. GALLIEN, DDS, PLLC
Entity type:Organization
Organization Name:ROBERT J. GALLIEN, DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:GALLIEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:423-894-5725
Mailing Address - Street 1:4618 HIGHWAY 58
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37416-3013
Mailing Address - Country:US
Mailing Address - Phone:423-894-5725
Mailing Address - Fax:423-321-8775
Practice Address - Street 1:4618 HIGHWAY 58
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37416-3013
Practice Address - Country:US
Practice Address - Phone:423-894-5725
Practice Address - Fax:423-321-8775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-30
Last Update Date:2015-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental