Individual
DR. WILLIAM JAMES GALLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
322 BAY ST, PETOSKEY, MI 49770-2489
(231) 347-1601
(231) 347-0330
Mailing address
322 BAY ST, PETOSKEY, MI 49770-2489
(231) 347-1601
(231) 347-0330
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
008828
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0B46032
BCBSM GROUP ID
MI
01
—
1154483014
NPI FACILITY
MI
01
—
WG008828
DENTAL LICENSE
MI
Enumeration date
11/30/2005
Last updated
03/07/2023
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