Gleason, Marcella Amanda

Gleason, Marcella Amanda is an individual health care provider with primary practice located at 201 Towne Dr , Elizabethtown KY 42701. She recently has 3 registered licenses in different health care specialties including Dental Providers / Dentist, Student, Health Care / Student in an Organized Health Care Education/Training Program, Dental Providers / General Practice. Dental Providers / General Practice is her primary health care specialty. Gleason, Marcella Amanda can be contacted via phone (844) 223-0008.

Contact Information

Primary practice address
201 Towne Dr Elizabethtown KY 42701
Phone: (844) 223-0008
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 9582 Kentucky
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Dental Providers / General Practice 1223G0001X 9582 Kentucky

Profile Details

NPI number 1467833194
LBN Legal business name Gleason, Marcella Amanda
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 18th, 2015
Last updated Jun 25th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467833194 NPPES
Kentucky MEDICAID 1467833194

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