Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 10747 | TN |
Y | 1223P0700X | Prosthodontist | 10747 | TN |
N | 1223P0700X | Prosthodontist | NJDIO18946 | NJ |
NPI | 1194946798 |
---|---|
Provider Name | Dr. Ramon Galvan |
First Address | Memphis, TN 38103-3513 |
Second Address | Memphis, TN 38103 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2007 |
Last Update Date | 01/06/2020 |