Healthcare Provider Details

I. General information

NPI: 1770964116
Provider Name (Legal Business Name): BENJAMIN T GALLION DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2015
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2326 MAIN ST
PARSONS KS
67357-2724
US

IV. Provider business mailing address

2326 MAIN ST
PARSONS KS
67357-2724
US

V. Phone/Fax

Practice location:
  • Phone: 620-421-1479
  • Fax: 620-421-1484
Mailing address:
  • Phone: 620-421-1479
  • Fax: 620-421-1484

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2015016955
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: