Individual
ROBIN LEE GALLARDI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSC DDS MSC FRCD(C)
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019029722
IL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
021002571
IL
Other
Enumeration date
06/11/2014
Last updated
06/11/2014
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