Provider Demographics
NPI:1528078391
Name:GALLOIS, ROBERT J (DMD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:J
Last Name:GALLOIS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:125 STRAWBERRY HILL AVENUE
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-2536
Mailing Address - Country:US
Mailing Address - Phone:203-348-7571
Mailing Address - Fax:203-359-8199
Practice Address - Street 1:125 STRAWBERRY HILL AVENUE
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-2536
Practice Address - Country:US
Practice Address - Phone:203-348-7571
Practice Address - Fax:203-359-8199
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT79271223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics