Provider Demographics
NPI:1063539765
Name:GOSLEE, MATTHEW TIMOTHY (DMD, MPH)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:TIMOTHY
Last Name:GOSLEE
Suffix:
Gender:M
Credentials:DMD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 SQUIRREL HILL LN
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06107-1035
Mailing Address - Country:US
Mailing Address - Phone:860-214-9745
Mailing Address - Fax:
Practice Address - Street 1:255 NORTH MAIN ST. C/O DR. MATT GOSLEE
Practice Address - Street 2:POSNER AND TURKUS DDS
Practice Address - City:BRISTOL
Practice Address - State:CT
Practice Address - Zip Code:06010
Practice Address - Country:US
Practice Address - Phone:860-589-7170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2009-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0095361223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry