Provider Demographics
NPI:1093861940
Name:GELBAND, MARK JOEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:JOEL
Last Name:GELBAND
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-1732
Mailing Address - Country:US
Mailing Address - Phone:732-741-1567
Mailing Address - Fax:732-741-3113
Practice Address - Street 1:200 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-1732
Practice Address - Country:US
Practice Address - Phone:732-741-1567
Practice Address - Fax:732-741-3113
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI011260001223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics