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General NPI Number Information
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NPI Number | 1871953646
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Entity Type | Organization
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Legal Business Name | MICHAEL A GERLACH DDS PLLC
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Dates
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Enumeration Date | 03/07/2016
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Last Update Date | 03/07/2016
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Provider Practice Location Address
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Address Line | 901 HILLCREST DR
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City | CONROE
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State | TX
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Zip | 77301-1106
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Country | US
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Telephone | 936-756-8115
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Fax |
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Provider Business Mailing Address
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Address Line | 901 HILLCREST DR
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City | CONROE
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State | TX
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Zip | 77301-1106
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Country | US
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Telephone | 936-756-8115
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. MICHAEL GERLACH
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Credential | DDS
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Telephone | 214-477-5106
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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 | 29997
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License Number State | TX
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