Individual
TRISTAN GALLOWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3600 S MIDLAND BLVD, NAMPA, ID 83686-8215
(208) 250-3115
Mailing address
3600 S MIDLAND BLVD, NAMPA, ID 83686-8215
(208) 250-3115
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D-4321
ID
Other
Enumeration date
08/19/2010
Last updated
08/19/2010
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