Provider Demographics
NPI:1154794550
Name:GALLOWAY DENTAL PLLC
Entity type:Organization
Organization Name:GALLOWAY DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HIREN
Authorized Official - Middle Name:A
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:817-801-9500
Mailing Address - Street 1:1930 E PARK ROW DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76010-4744
Mailing Address - Country:US
Mailing Address - Phone:817-801-9500
Mailing Address - Fax:817-801-9501
Practice Address - Street 1:3330 N GALLOWAY AVE
Practice Address - Street 2:SUITE 158
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-4728
Practice Address - Country:US
Practice Address - Phone:817-801-9500
Practice Address - Fax:817-801-9501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-06
Last Update Date:2015-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX27622122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty