Provider Demographics
NPI:1821108697
Name:GERIGK, CAROLA A (DDS)
Entity Type:Individual
Prefix:DR
First Name:CAROLA
Middle Name:A
Last Name:GERIGK
Suffix:
Gender:F
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:PO BOX 125
Mailing Address - Street 2:
Mailing Address - City:SALINE
Mailing Address - State:MI
Mailing Address - Zip Code:48176
Mailing Address - Country:US
Mailing Address - Phone:734-429-8558
Mailing Address - Fax:
Practice Address - Street 1:104 MILLS RD
Practice Address - Street 2:
Practice Address - City:SALINE
Practice Address - State:MI
Practice Address - Zip Code:48176
Practice Address - Country:US
Practice Address - Phone:734-429-8558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2901015699122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist