Provider Demographics
NPI:1184839391
Name:GEROFF, CHRIS V (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:V
Last Name:GEROFF
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 660
Mailing Address - Street 2:195 MAIN ST
Mailing Address - City:GAINESVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:65655-0660
Mailing Address - Country:US
Mailing Address - Phone:417-679-3509
Mailing Address - Fax:
Practice Address - Street 1:195 MAIN STREET
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:MO
Practice Address - Zip Code:65655
Practice Address - Country:US
Practice Address - Phone:417-679-3509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MODE0108231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MODE010823OtherMO LICENSE NUMBER
MODE010823OtherMO LICENSE NUMBER