Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 831 | CO |
NPI | 1043218910 |
---|---|
Provider Name | James H Gallagher |
First Address | Arvada, CO 80005-4450 |
Second Address | Arvada, CO 80005-5032 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2005 |
Last Update Date | 08/07/2007 |