Organization
TRISTAN GALLOWAY DDS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRISTAN SUMNER GALLOWAY DDS (OOWNER/OPERATOR)
(208) 466-4261
Entity
Organization
Contact information
Practice address
820 17TH AVE S, NAMPA, ID 83651-4740
(208) 466-4261
(208) 466-6288
Mailing address
820 17TH AVE S, NAMPA, ID 83651-4740
(208) 466-4261
(208) 466-6288
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D4321
ID
Other
Enumeration date
09/03/2014
Last updated
09/03/2014
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