Healthcare Provider Details

I. General information

NPI: 1346245941
Provider Name (Legal Business Name): MARIE A GALE D.D.S., M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2005
Last Update Date: 04/05/2021
Certification Date: 04/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1994 W RIVER AVE
OSCODA MI
48750-9295
US

IV. Provider business mailing address

1994 W RIVER AVE
OSCODA MI
48750-9295
US

V. Phone/Fax

Practice location:
  • Phone: 239-936-2221
  • Fax:
Mailing address:
  • Phone: 239-936-2221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License NumberDN8521
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: