Provider Demographics
NPI:1376647008
Name:GERWIG, CHRISTOPHER MATTHEW (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:MATTHEW
Last Name:GERWIG
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 1:4805 99TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-6357
Mailing Address - Country:US
Mailing Address - Phone:806-786-5844
Mailing Address - Fax:
Practice Address - Street 1:4425 98TH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-5029
Practice Address - Country:US
Practice Address - Phone:806-794-7479
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2014-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX226801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice