Provider Demographics
NPI:1164460606
Name:JOHN F GELETKA DDS
Entity Type:Organization
Organization Name:JOHN F GELETKA DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:F
Authorized Official - Last Name:GELETKA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:330-792-1485
Mailing Address - Street 1:5121 MAHONING AVENUE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515
Mailing Address - Country:US
Mailing Address - Phone:330-792-1485
Mailing Address - Fax:330-792-0398
Practice Address - Street 1:5121 MAHONING AVENUE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515
Practice Address - Country:US
Practice Address - Phone:330-792-1485
Practice Address - Fax:330-792-0398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30012676122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty