Provider Demographics
NPI:1720593932
Name:GERNERT, FRAN (CDA)
Entity Type:Individual
Prefix:MS
First Name:FRAN
Middle Name:
Last Name:GERNERT
Suffix:
Gender:F
Credentials:CDA
Other - Prefix:MS
Other - First Name:FRANCINE
Other - Middle Name:
Other - Last Name:GERNERT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CDA
Mailing Address - Street 1:1667 COCHRANE CIR BLDG 7495
Mailing Address - Street 2:
Mailing Address - City:FORT CARSON
Mailing Address - State:CO
Mailing Address - Zip Code:80913-4603
Mailing Address - Country:US
Mailing Address - Phone:719-526-5380
Mailing Address - Fax:
Practice Address - Street 1:1667 COCHRANE CIR BLDG 7495
Practice Address - Street 2:
Practice Address - City:FORT CARSON
Practice Address - State:CO
Practice Address - Zip Code:80913-4603
Practice Address - Country:US
Practice Address - Phone:719-526-5380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-11
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant