Provider Demographics
NPI:1871700484
Name:GALINIS, SHANNON P (DMD)
Entity type:Individual
Prefix:DR
First Name:SHANNON
Middle Name:P
Last Name:GALINIS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:SHANNON
Other - Middle Name:
Other - Last Name:PLYMALE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:2812 SW MAPP RD
Mailing Address - Street 2:
Mailing Address - City:PALM CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34990-2722
Mailing Address - Country:US
Mailing Address - Phone:772-220-8750
Mailing Address - Fax:772-220-8750
Practice Address - Street 1:2812 SW MAPP RD
Practice Address - Street 2:
Practice Address - City:PALM CITY
Practice Address - State:FL
Practice Address - Zip Code:34990-2722
Practice Address - Country:US
Practice Address - Phone:772-220-8750
Practice Address - Fax:772-220-8750
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist