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General NPI Number Information
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NPI Number | 1861753584
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Entity Type | Organization
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Legal Business Name | JAMES V. GALIANO III, DMD LLC
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Dates
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Enumeration Date | 05/30/2012
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Last Update Date | 05/30/2012
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Provider Practice Location Address
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Address Line | 11 N BEVERWYCK RD
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City | LAKE HIAWATHA
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State | NJ
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Zip | 07034-2518
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Country | US
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Telephone | 973-334-0212
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Fax |
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Provider Business Mailing Address
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Address Line | 11 N BEVERWYCK RD
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City | LAKE HIAWATHA
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State | NJ
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Zip | 07034-2518
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Country | US
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Telephone | 973-334-0212
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JAMES V GALIANO III
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Credential | DMD
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Telephone | 973-727-8269
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 22DI02101400
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License Number State | NJ
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