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General NPI Number Information
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NPI Number | 1760512081
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Entity Type | Organization
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Legal Business Name | GEARHART FAMILY DENTISTRY
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1618 S ALABAMA AVE
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City | MONROEVILLE
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State | AL
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Zip | 36460-3078
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Country | US
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Telephone | 251-743-3123
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Fax | 251-575-5965
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Provider Business Mailing Address
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Address Line | 1618 S ALABAMA AVE
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City | MONROEVILLE
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State | AL
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Zip | 36460-3078
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Country | US
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Telephone | 251-743-3123
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Fax | 251-575-5965
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Authorized Official
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Title or Position | DOCTOR
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Name | ANDREW GEARHART
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Credential | D.M.D
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Telephone | 251-743-3123
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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