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General NPI Number Information
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NPI Number | 1538289103
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Entity Type | Individual
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Provider Name | GREGORY W. GELDART D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 06/01/2010
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Provider Practice Location Address
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Address Line | 46400 BENEDICT DR SUITE 205
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City | STERLING
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State | VA
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Zip | 20164-6604
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Country | US
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Telephone | 703-430-6432
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Fax |
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Provider Business Mailing Address
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Address Line | 17340 PICKWICK DRIVE SUITE 100
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City | PURCELLVILLE
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State | VA
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Zip | 20132
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Country | US
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Telephone | 540-338-3186
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Fax | 540-338-3759
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 0401006764
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License Number State | VA
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