Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 4621 | CT |
NPI | 1033279658 |
---|---|
Provider Name | Dr. David A Gelb |
First Address | West Hartford, CT 06119 |
Second Address | West Hartford, CT 06119 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2006 |
Last Update Date | 08/07/2007 |