Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1101X | Ophthalmic Assistant | 2035 | FL |
NPI | 1447304753 |
---|---|
Provider Name | Mr. Dennis William Gallagher |
First Address | Tequesta, FL 33469-3060 |
Second Address | Tequesta, FL 33469-3060 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2007 |
Last Update Date | 08/07/2007 |