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General NPI Number Information
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NPI Number | 1215227319
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Entity Type | Organization
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Legal Business Name | MARIE A. GALE
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Dates
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Enumeration Date | 04/11/2011
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Last Update Date | 04/18/2011
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Provider Practice Location Address
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Address Line | 5285 SUMMERLIN RD SUITE 401
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City | FORT MYERS
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State | FL
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Zip | 33919-7601
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Country | US
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Telephone | 239-936-2221
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Fax |
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Provider Business Mailing Address
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Address Line | 5285 SUMMERLIN RD SUITE 401
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City | FORT MYERS
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State | FL
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Zip | 33919-7601
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Country | US
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Telephone | 239-936-2221
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Fax |
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | DR. MARIE A GALE
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Credential | D.D.S., M.S.
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Telephone | 239-936-2221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | DN8521
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License Number State | FL
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