Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | DN16549 | FL |
NPI | 1073633707 |
---|---|
Provider Name | Dr. Stephen Thomas Galla |
First Address | Palm Beach Gardens, FL 33410-3446 |
Second Address | Palm Beach Gardens, FL 33410-3446 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2007 |
Last Update Date | 08/07/2007 |