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General NPI Number Information
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NPI Number | 1992927669
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Entity Type | Organization
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Legal Business Name | GEORGE GAILLARDETZ DMD, INC
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 03/27/2008
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Provider Practice Location Address
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Address Line | 26 BAY ST
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City | WOLFEBORO
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State | NH
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Zip | 03894-4320
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Country | US
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Telephone | 603-569-2268
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Fax | 603-569-5837
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Provider Business Mailing Address
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Address Line | PO BOX 998
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City | WOLFEBORO FALLS
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State | NH
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Zip | 03896-0998
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Country | US
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Telephone | 603-569-2268
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Fax | 603-569-5837
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Authorized Official
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Title or Position | OWNER
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Name | DR. GEORGE ARMAND GAILLARDETZ
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Credential | DMD
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Telephone | 603-569-2268
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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 | 2295
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License Number State | NH
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