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Individual

DR. MARCELLA AMANDA GLEASON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.M.D.

Contact information

Practice address
1750 LEITCHFIELD RD, ELIZABETHTOWN, KY 42701-3281
(317) 442-9757
Mailing address
155 BETH CT, ELIZABETHTOWN, KY 42701-8596
(270) 317-4149

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
9582
KY
1223G0001X
General Practice Dentistry
Primary
9582
KY
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1467833194
KY
Enumeration date
06/18/2015
Last updated
03/05/2026
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