Doctor Name: | DR. MICHELE ELLEN GLADSTONE |
NPI Number: | 1164524526 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DDS |
License Number: | D2228597 |
Business Practice Address: | 920 Town Center Dr Suite I30 Oxford Court Business Center Langhorne, PA - 19047 |
Business Phone Number: | 2157524490 |
Business Fax Number: | 2157527634 |
Mailing Address: | 920 Town Center Dr, Suite I30 Oxford Court Business Center LANGHORNE |
State: | PA |
Postal Code: | 19047 |
Phone Number: | 2157524490 |
Fax Number: | 2157527634 |
NPI Enumeration Date: | 09/05/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | D2228597 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |