Healthcare Provider Details

I. General information

NPI: 1336482819
Provider Name (Legal Business Name): JOHN V GALINAITIS DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2013
Last Update Date: 04/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

252 E BALTIMORE ST
TANEYTOWN MD
21787-2225
US

IV. Provider business mailing address

252 E BALTIMORE ST
TANEYTOWN MD
21787-2225
US

V. Phone/Fax

Practice location:
  • Phone: 410-751-1023
  • Fax:
Mailing address:
  • Phone: 410-751-1023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number10565
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: