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General NPI Number Information
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NPI Number | 1780783894
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Entity Type | Organization
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Legal Business Name | SCOTT D. GALKIN, D.M.D, P.A.
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Dates
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Enumeration Date | 09/22/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 711 AMBOY AVE
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City | WOODBRIDGE
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State | NJ
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Zip | 07095-3139
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Country | US
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Telephone | 732-750-2600
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Fax |
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Provider Business Mailing Address
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Address Line | 711 AMBOY AVE
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City | WOODBRIDGE
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State | NJ
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Zip | 07095-3139
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SCOTT D GALKIN
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Credential | D.M.D.
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Telephone | 732-750-2600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 22DI02077400
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License Number State | NJ
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