Tristan Galloway DDS Pllc

NPI #1942600390 in Nampa, Idaho

Provider Information

NPI Number: 1942600390
Entity Type: Organization
Organization Name: Tristan Galloway DDS Pllc
Primary Specialty: Dentist
Enumeration Date: Sep 3, 2014
Last Updated: Sep 3, 2014

Practice Location

Address: 820 17TH AVE S
City: Nampa
State: Idaho
ZIP Code: 83651-4740
Phone: (208) 466-4261

Authorized Official

Name: TRISTAN SUMNER GALLOWAY, DDS
Title: OOWNER/OPERATOR
Phone: (208) 466-4261

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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