Healthcare Provider Details

I. General information

NPI: 1740339183
Provider Name (Legal Business Name): BARRY JOEL GELBER DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1185 SILAS DEANE HWY
WETHERSFIELD CT
06109
US

IV. Provider business mailing address

1185 SILAS DEANE HWY
WETHERSFIELD CT
06109
US

V. Phone/Fax

Practice location:
  • Phone: 860-563-2331
  • Fax:
Mailing address:
  • Phone: 860-563-2331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number4950
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: