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General NPI Number Information
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NPI Number | 1184834129
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Entity Type | Organization
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Legal Business Name | RYAN C. GALLIGAN, DDS, PA
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 03/26/2014
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Provider Practice Location Address
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Address Line | 11420 FALLS OF NEUSE RD
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City | WAKE FOREST
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State | NC
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Zip | 27587
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Country | US
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Telephone | 919-562-5433
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Fax |
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Provider Business Mailing Address
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Address Line | 11420 FALLS OF NEUSE RD
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City | WAKE FOREST
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State | NC
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Zip | 27587
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | RYAN GALLIGAN
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Credential |
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Telephone | 919-562-5433
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 7978
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License Number State | NC
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