Provider Demographics
NPI:1689681330
Name:GERBER, JIRARD MELVIN (DMD)
Entity Type:Individual
Prefix:
First Name:JIRARD
Middle Name:MELVIN
Last Name:GERBER
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 1:4999 JONESTOWN RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17109-1743
Mailing Address - Country:US
Mailing Address - Phone:717-652-3094
Mailing Address - Fax:717-652-3314
Practice Address - Street 1:4999 JONESTOWN RD
Practice Address - Street 2:SUITE 102
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-1743
Practice Address - Country:US
Practice Address - Phone:717-652-3094
Practice Address - Fax:717-652-3314
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS024951L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice