Provider Demographics
NPI:1235262874
Name:GERARD, NICHOLAS O (DMD MD)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:O
Last Name:GERARD
Suffix:
Gender:M
Credentials:DMD MD
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Mailing Address - Street 1:1650 BONNIE LN STE 101
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38016-0517
Mailing Address - Country:US
Mailing Address - Phone:901-275-8159
Mailing Address - Fax:901-907-0057
Practice Address - Street 1:2675 CENTRAL AVE
Practice Address - Street 2:STE L8
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-6686
Practice Address - Country:US
Practice Address - Phone:406-652-8411
Practice Address - Fax:406-652-7905
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN88891223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery