Individual
DR. GEORGE A GAILLARDETZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1127 QUEENSBOROUGH BLVD STE 107, MOUNT PLEASANT, SC 29464-5432
(603) 569-2268
(603) 569-5837
Mailing address
1127 QUEENSBOROUGH BLVD STE 107, MOUNT PLEASANT, SC 29464-5432
(843) 352-9430
(843) 352-9731
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2295
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020433005
NE DELTA DENTAL PAYEE #
NH
05
—
30003379
—
NH
Enumeration date
06/12/2006
Last updated
06/17/2019
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