Provider Demographics
NPI:1790834075
Name:GNERRE, JOHN F (DDS)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:F
Last Name:GNERRE
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 1:128 BEDFORD RD
Mailing Address - Street 2:
Mailing Address - City:KATONAH
Mailing Address - State:NY
Mailing Address - Zip Code:10536-2108
Mailing Address - Country:US
Mailing Address - Phone:914-232-5425
Mailing Address - Fax:914-232-7677
Practice Address - Street 1:128 BEDFORD RD
Practice Address - Street 2:
Practice Address - City:KATONAH
Practice Address - State:NY
Practice Address - Zip Code:10536-2108
Practice Address - Country:US
Practice Address - Phone:914-232-5425
Practice Address - Fax:914-232-7677
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031713122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist