Healthcare Provider Details

I. General information

NPI: 1972557999
Provider Name (Legal Business Name): BRET D. GELDER DDS,MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1070 NOTT ST
SCHENECTADY NY
12308-2410
US

IV. Provider business mailing address

1070 NOTT ST
SCHENECTADY NY
12308-2410
US

V. Phone/Fax

Practice location:
  • Phone: 518-374-9109
  • Fax: 518-374-1978
Mailing address:
  • Phone: 518-374-9109
  • Fax: 518-374-1978

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number047593
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: