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NPI 1780781112

NPI 1780781112 : PAUL W GALITSIS DMD : WESTWOOD, NJ

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General NPI Number Information
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    NPI Number           |    1780781112
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    Entity Type          |    Individual 
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    Provider Name        |    PAUL W GALITSIS DMD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    09/20/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    345 KINDERKAMACK RD STE D 
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    City                 |    WESTWOOD
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    State                |    NJ
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    Zip                  |    07675-1600
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    Country              |    US
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    Telephone            |    201-664-0767
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    Fax                  |    201-664-2334
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Provider Business Mailing Address
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    Address Line         |    345 KINDERKAMACK RD SUITE D
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    City                 |    WESTWOOD
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    State                |    NJ
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    Zip                  |    07675
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    Country              |    US
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    Telephone            |    201-664-0767
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    Fax                  |    201-664-2334
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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        |    1223P0700X
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    Taxonomy Name        |    Prosthodontics
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    License Number       |    22DI01578200
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    License Number State |    NJ
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