Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223S0112X | Oral and Maxillofacial Surgeon | 166 | OK |
Y | 1223S0112X | Oral and Maxillofacial Surgeon | DE60353083 | WA |
NPI | 1093977506 |
---|---|
Provider Name | Dr. David G. Gailey |
First Address | Spokane, WA 99203-3961 |
Second Address | Spokane, WA 99203-3961 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2008 |
Last Update Date | 09/12/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1093977506 | (05) | WA |