# GALLUP DENTAL INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1447356639
- **Authorized official:** PAULA DEANNE GALLUP DDS (DENTIST)
- **Authorized official phone:** (903) 872-3981

## Contact information

- **Practice address:** 218 W 2ND AVE, CORSICANA, TX 75110
- **Practice address phone:** (903) 872-3981
- **Practice address fax:** (903) 872-0835
- **Mailing address:** 218 W 2ND AVE, CORSICANA, TX 75110
- **Mailing address phone:** (903) 872-3981
- **Mailing address fax:** (903) 872-0835

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 17139 | TX | — |
| 122300000X | Dentist | 18748 | TX | Yes |

## Other

- **Enumeration date:** 09/15/2006
- **Last updated:** 08/22/2020