Healthcare Provider Details

I. General information

NPI: 1881742591
Provider Name (Legal Business Name): GELNETT INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 BARLOWS LANDING RD SUITE 20
POCASSET MA
02559-1980
US

IV. Provider business mailing address

4 BARLOWS LANDING RD SUITE 20
POCASSET MA
02559-1980
US

V. Phone/Fax

Practice location:
  • Phone: 508-564-7570
  • Fax: 508-564-7571
Mailing address:
  • Phone: 508-564-7570
  • Fax: 508-564-7571

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number20532
License Number StateMA

VIII. Authorized Official

Name: DR. JULIE A GELNETT
Title or Position: PRESIDENT
Credential: D.M.D.
Phone: 508-564-7570