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General NPI Number Information
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NPI Number | 1528468352
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Entity Type | Individual
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Provider Name | GARY GERSH D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 08/28/2014
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Last Update Date | 08/28/2014
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Provider Practice Location Address
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Address Line | 5211 WAYNETOWNE CT
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City | HUBER HEIGHTS
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State | OH
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Zip | 45424-2124
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Country | US
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Telephone | 937-278-7417
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Fax |
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Provider Business Mailing Address
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Address Line | 7575 PELICAN BAY BLVD
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City | NAPLES
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State | FL
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Zip | 34108-7532
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Country | US
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Telephone | 239-566-2525
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 30012462
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License Number State | OH
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