Healthcare Provider Details

I. General information

NPI: 1407992100
Provider Name (Legal Business Name): DAVID M. GEJER DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 W BLACK HORSE PIKE
PLEASANTVILLE NJ
08232-2645
US

IV. Provider business mailing address

8 BALTUSROL TER
MOORESTOWN NJ
08057-3952
US

V. Phone/Fax

Practice location:
  • Phone: 609-641-1065
  • Fax: 609-645-0162
Mailing address:
  • Phone: 609-641-1065
  • Fax: 609-645-0162

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number22DI01122500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: