Provider Demographics
NPI:1689074551
Name:MICHAEL L GELB DDS MS P C
Entity Type:Organization
Organization Name:MICHAEL L GELB DDS MS P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GELB
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:212-752-1661
Mailing Address - Street 1:12 OLD MAMARONECK RD
Mailing Address - Street 2:STE 1C
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-2010
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12 OLD MAMARONECK RD
Practice Address - Street 2:STE 1C
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-2010
Practice Address - Country:US
Practice Address - Phone:212-752-1662
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-28
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty
No261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain