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General NPI Number Information
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NPI Number | 1770789455
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Entity Type | Individual
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Provider Name | CHARLOTTE YVONNE GERRY DMD
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Gender | Female
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Dates
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Enumeration Date | 06/21/2007
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Last Update Date | 04/11/2021
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Provider Practice Location Address
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Address Line | 5650 FULCHER AVE
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91601-1942
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Country | US
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Telephone | 904-236-2068
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Fax |
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Provider Business Mailing Address
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Address Line | 5650 FULCHER AVE
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91601-1942
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Country | US
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Telephone | 904-236-2068
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DN0014223
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DN0014223
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DDS61128
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License Number State | CA
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