Provider Demographics
NPI:1265471239
Name:GERBER DENTAL GROUP
Entity Type:Organization
Organization Name:GERBER DENTAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:PARE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-669-4111
Mailing Address - Street 1:50 BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03101-1699
Mailing Address - Country:US
Mailing Address - Phone:603-669-4111
Mailing Address - Fax:603-641-2706
Practice Address - Street 1:50 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03101-1699
Practice Address - Country:US
Practice Address - Phone:603-669-4111
Practice Address - Fax:603-641-2706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH31351223G0001X
NH25831223G0001X
NH25901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty