Individual
DR. BRUCE V GALLUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
211 MOUNT AUBURN AVE, AUBURN, ME 04210-8521
(207) 514-7171
(207) 514-7177
Mailing address
211 MOUNT AUBURN AVE, AUBURN, ME 04210-8521
(207) 514-7171
(207) 514-7177
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
3223
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
269850099
—
ME
Enumeration date
05/27/2005
Last updated
11/29/2012
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