Gallup, Bruce V

Gallup, Bruce V is an individual health care provider with primary practice located at 211 Mount Auburn Ave , Auburn ME 04210-8521. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Gallup, Bruce V can be contacted via phone (207) 514-7171.

Contact Information

Primary practice address
211 Mount Auburn Ave Auburn ME 04210-8521
Phone: (207) 514-7171
Fax: (207) 514-7177
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 3223 Maine

Profile Details

NPI number 1790788487
LBN Legal business name Gallup, Bruce V
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 27th, 2005
Last updated Nov 29th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790788487 NPPES
Maine MEDICAID 269850099

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