Provider Demographics
NPI:1477574242
Name:GEELAN, DANIEL BRIAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:BRIAN
Last Name:GEELAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 W AVON RD
Mailing Address - Street 2:AVON DENTAL GROUP
Mailing Address - City:AVON
Mailing Address - State:CT
Mailing Address - Zip Code:06001-3677
Mailing Address - Country:US
Mailing Address - Phone:860-673-0451
Mailing Address - Fax:
Practice Address - Street 1:20 W AVON RD
Practice Address - Street 2:AVON DENTAL GROUP
Practice Address - City:AVON
Practice Address - State:CT
Practice Address - Zip Code:06001-3677
Practice Address - Country:US
Practice Address - Phone:860-673-0451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT7981122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist