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General NPI Number Information
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NPI Number | 1528982188
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Entity Type | Organization
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Legal Business Name | BIG CREEK FAMILY DENTAL PLLC
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Dates
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Enumeration Date | 08/06/2026
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Last Update Date | 08/06/2026
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Provider Practice Location Address
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Address Line | 1049 PARKER BLVD. SUITE 100
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City | POLK CITY
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State | IA
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Zip | 50226
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Country | US
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Telephone | 515-800-7183
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Fax |
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Provider Business Mailing Address
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Address Line | 1919 NW BEECHWOOD ST
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City | ANKENY
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State | IA
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Zip | 50023-1166
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ABAGAIL GERHARDT
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Credential | DDS
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Telephone | 515-800-7183
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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