Healthcare Provider Details

I. General information

NPI: 1760492532
Provider Name (Legal Business Name): ROBERT M GELL DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 GROVE ST
RIDGEFIELD CT
06877
US

IV. Provider business mailing address

80 GROVE ST
RIDGEFIELD CT
06877
US

V. Phone/Fax

Practice location:
  • Phone: 203-438-7280
  • Fax:
Mailing address:
  • Phone: 203-438-7280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number5109
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: