Individual
DR. KRISTINE A GLEASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD, MD
Contact information
Practice address
992 MANTUA PIKE STE 302, WOODBURY HEIGHTS, NJ 08097-1249
(856) 845-1341
(856) 384-9067
Mailing address
992 MANTUA PIKE, STE 302, WOODBURY HEIGHTS, NJ 08097-1249
(215) 662-3586
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
22DI02827500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22-2218302
FEIN
NJ
Enumeration date
06/20/2013
Last updated
03/15/2023
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