Provider Demographics
NPI:1821461385
Name:GREGORY W GELDART DMD PLC
Entity Type:Organization
Organization Name:GREGORY W GELDART DMD PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:GELDART
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:540-338-3186
Mailing Address - Street 1:17340 PICKWICK DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PURCELLVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20132-6181
Mailing Address - Country:US
Mailing Address - Phone:540-338-3186
Mailing Address - Fax:
Practice Address - Street 1:17340 PICKWICK DR
Practice Address - Street 2:SUITE 100
Practice Address - City:PURCELLVILLE
Practice Address - State:VA
Practice Address - Zip Code:20132-6181
Practice Address - Country:US
Practice Address - Phone:540-338-3186
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:POTOMAC VALLEY DENTAL CARE PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-11-05
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty