Healthcare Provider Details

I. General information

NPI: 1275803322
Provider Name (Legal Business Name): MARC B. GELBER DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2012
Last Update Date: 01/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 NEW MONMOUTH RD
MIDDLETOWN NJ
07748-2232
US

IV. Provider business mailing address

133 NEW MONMOUTH RD
MIDDLETOWN NJ
07748-2232
US

V. Phone/Fax

Practice location:
  • Phone: 732-671-3501
  • Fax: 732-671-3503
Mailing address:
  • Phone: 732-671-3501
  • Fax: 732-671-3503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberD02669500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: