MEDICARE: MARIE A. GALE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0700X	Prosthodontics	DN8521	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215227319
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARIE A. GALE

Provider Business Mailing Address
First Line	:	5285 SUMMERLIN RD
Second Line	:	SUITE 401
City	:	FORT MYERS
State	:	FL
Zip	:	33919-7601
Country	:	US
Telephone Number	:	239-936-2221
Fax Number	:

Provider Business Practice Location Address
First Line	:	5285 SUMMERLIN RD
Second Line	:	SUITE 401
City	:	FORT MYERS
State	:	FL
Zip	:	33919-7601
Country	:	US
Telephone Number	:	239-936-2221
Fax Number	:

Authorized Official
Title or Position	:	SOLE PROPRIETOR
Name	:	DR. MARIE A GALE
Credential	:	D.D.S., M.S.
Telephone Number	:	239-936-2221

Provider Enumeration Date	:	04/11/2011
Last Update Date	:	04/18/2011

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