Provider Demographics
NPI:1518160415
Name:GERBHOLZ-VIEREGGER DDS PC
Entity Type:Organization
Organization Name:GERBHOLZ-VIEREGGER DDS PC
Other - Org Name:GLOW COMPREHENSIVE DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:HUGO
Authorized Official - Last Name:GERBHOLZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:303-688-5705
Mailing Address - Street 1:850 HAPPY CANYON RD
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80108
Mailing Address - Country:US
Mailing Address - Phone:303-688-5705
Mailing Address - Fax:303-688-5731
Practice Address - Street 1:850 HAPPY CANYON RD
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80108-3908
Practice Address - Country:US
Practice Address - Phone:303-688-5705
Practice Address - Fax:303-688-5731
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental