Provider Demographics
NPI:1558926832
Name:EDELMANN, GABRIELLE KRISTINE (DMD)
Entity Type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:KRISTINE
Last Name:EDELMANN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1616 13TH AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-3840
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1001 W INDIANTOWN RD PREMIER DENTISTRY OF JUPITER
Practice Address - Street 2:#106
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458
Practice Address - Country:US
Practice Address - Phone:561-747-7111
Practice Address - Fax:561-747-8826
Is Sole Proprietor?:No
Enumeration Date:2019-05-02
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program