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General NPI Number Information
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NPI Number | 1407846892
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Entity Type | Individual
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Provider Name | GREGORY J GAGLIARDI D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/26/2005
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Last Update Date | 11/16/2018
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Provider Practice Location Address
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Address Line | 854 SECOND STREET PIKE
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City | RICHBORO
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State | PA
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Zip | 18954
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Country | US
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Telephone | 215-355-3141
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Fax | 215-355-3999
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Provider Business Mailing Address
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Address Line | 854 SECOND STREET PIKE
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City | RICHBORO
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State | PA
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Zip | 18954
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Country | US
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Telephone | 215-355-3141
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Fax | 215-355-3999
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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 | DS026956L
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License Number State | PA
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