Individual
RYAN KADE GALLEGOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1275 N TRUMAN BLVD, FESTUS, MO 63028-1176
(844) 853-8937
Mailing address
1800 COMMUNITY, CLINTON, MO 64735-8804
(660) 885-8131
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
30.027414
OH
1223G0001X
General Practice Dentistry
Primary
2025012508
MO
1223P0221X
Pediatric Dentistry
30.027414
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0051210
—
OH
Enumeration date
02/13/2023
Last updated
08/04/2025
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