Provider Demographics
NPI:1427182153
Name:GERSTLEY, DOROTHY MAE (DMD)
Entity Type:Individual
Prefix:DR
First Name:DOROTHY
Middle Name:MAE
Last Name:GERSTLEY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:0260 EQUESTRIAN WAY
Mailing Address - Street 2:
Mailing Address - City:CARBONDALE
Mailing Address - State:CO
Mailing Address - Zip Code:81623-9133
Mailing Address - Country:US
Mailing Address - Phone:970-704-0348
Mailing Address - Fax:
Practice Address - Street 1:289 MAIN STREET
Practice Address - Street 2:
Practice Address - City:CARBONDALE
Practice Address - State:CO
Practice Address - Zip Code:81623-2138
Practice Address - Country:US
Practice Address - Phone:970-963-3010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO84521223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics