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General NPI Number Information
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NPI Number | 1437686839
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Entity Type | Individual
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Provider Name | AIDAN SEAN GALLAGHER DDS
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Gender | Male
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Dates
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Enumeration Date | 05/16/2017
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Last Update Date | 02/02/2023
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Provider Practice Location Address
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Address Line | 220 CUMBERLAND PKWY STE 6
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City | MECHANICSBURG
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State | PA
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Zip | 17055-5683
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Country | US
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Telephone | 732-986-3690
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Fax |
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Provider Business Mailing Address
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Address Line | 18 CAMPUS BLVD., SUITE 100 OFFICE 115
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City | NEWTOWN SQUARE
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State | PA
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Zip | 19073
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Country | US
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Telephone | 484-319-6496
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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 | 1223D0004X
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Taxonomy Name | Dental Anesthesiology
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License Number | 22DI02937000
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1223D0004X
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Taxonomy Name | Dental Anesthesiology
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License Number | DS043445
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License Number State | PA
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