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General NPI Number Information
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NPI Number | 1336115245
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Entity Type | Individual
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Provider Name | JON P. GALEA D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 02/28/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 8981 W SAHARA AVE SUITE 110
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City | LAS VEGAS
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State | NV
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Zip | 89117-5897
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Country | US
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Telephone | 702-254-4220
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Fax |
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Provider Business Mailing Address
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Address Line | 4472 PROSPECT HILL COURT
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City | LAS VEGAS
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State | NV
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Zip | 89129
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Country | US
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Telephone | 702-645-9149
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 4182
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License Number State | NV
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