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General NPI Number Information
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NPI Number | 1184756215
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Entity Type | Individual
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Provider Name | KIRSTEN GALAYDA DDS
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Gender | Female
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Dates
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Enumeration Date | 03/12/2007
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Last Update Date | 02/19/2009
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Provider Practice Location Address
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Address Line | 715 ELA RD SUITE 1A
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City | LAKE ZURICH
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State | IL
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Zip | 60047-6300
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Country | US
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Telephone | 847-726-2908
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Fax |
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Provider Business Mailing Address
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Address Line | 400 W ONTARIO ST UNIT 609
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City | CHICAGO
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State | IL
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Zip | 60654-6890
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Country | US
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Telephone | 312-951-1178
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 019026512
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License Number State | IL
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