Healthcare Provider Details

I. General information

NPI: 1841303278
Provider Name (Legal Business Name): STEVEN A GELLER DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 RIDDELL ST
GREENFIELD MA
01301-2025
US

IV. Provider business mailing address

54 ROSEWOOD LN
SPOFFORD NH
03462-4422
US

V. Phone/Fax

Practice location:
  • Phone: 413-773-7100
  • Fax: 413-774-7271
Mailing address:
  • Phone: 603-363-8910
  • Fax: 413-774-7271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number13181
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: