Provider Demographics
NPI:1417334293
Name:GALVIN, GRETCHEN (DDS)
Entity type:Individual
Prefix:DR
First Name:GRETCHEN
Middle Name:
Last Name:GALVIN
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4909 TRANSIT RD
Mailing Address - Street 2:
Mailing Address - City:DEPEW
Mailing Address - State:NY
Mailing Address - Zip Code:14043-4686
Mailing Address - Country:US
Mailing Address - Phone:716-656-8686
Mailing Address - Fax:
Practice Address - Street 1:4909 TRANSIT RD STE 2
Practice Address - Street 2:
Practice Address - City:DEPEW
Practice Address - State:NY
Practice Address - Zip Code:14043-4686
Practice Address - Country:US
Practice Address - Phone:716-631-2728
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-30
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY058513-11223G0001X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice