MEDICARE: DAVID C GEHRING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	7644	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	872922	OTHER	IA	UNITED CONCORDIA
2	51479	OTHER	IA	BLUE CROSS BLUE SHIELD
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508031642
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID C GEHRING

Provider Business Mailing Address
First Line	:	5012 CENTER POINT RD NE
Second Line	:
City	:	CEDAR RAPIDS
State	:	IA
Zip	:	52402-2465
Country	:	US
Telephone Number	:	319-378-3333
Fax Number	:	319-378-3332

Provider Business Practice Location Address
First Line	:	5012 CENTER POINT RD NE
Second Line	:
City	:	CEDAR RAPIDS
State	:	IA
Zip	:	52402-2465
Country	:	US
Telephone Number	:	319-378-3333
Fax Number	:	319-378-3332

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/29/2008
Last Update Date	:	04/29/2008

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Directions to “ DAVID C GEHRING ” Practice Location

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