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General NPI Number Information
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NPI Number | 1477846632
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Entity Type | Individual
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Provider Name | PATRICK BRANNON GALLOWAY DDS, MS
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Gender | Male
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Dates
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Enumeration Date | 05/20/2011
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Last Update Date | 11/07/2024
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Provider Practice Location Address
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Address Line | 102 MEDICAL DRIVE
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City | DOTHAN
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State | AL
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Zip | 36303
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Country | US
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Telephone | 334-792-7888
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Fax | 334-792-8717
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Provider Business Mailing Address
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Address Line | 102 MEDICAL DRIVE
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City | DOTHAN
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State | AL
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Zip | 36303
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Country | US
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Telephone | 334-792-7888
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Fax | 334-792-8717
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 9111
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 6169
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License Number State | AL
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