Provider Demographics
NPI:1285841908
Name:GERIC, CHRISTOPHER MARC (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:MARC
Last Name:GERIC
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8225 SEVEN MILE DR
Mailing Address - Street 2:
Mailing Address - City:PONTE VEDRA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32082-3132
Mailing Address - Country:US
Mailing Address - Phone:904-260-6111
Mailing Address - Fax:904-260-6331
Practice Address - Street 1:12078 SAN JOSE BLVD
Practice Address - Street 2:SUITE 3
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32223-8670
Practice Address - Country:US
Practice Address - Phone:904-260-6111
Practice Address - Fax:904-260-6331
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN156581223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics