Provider Demographics
NPI:1851330054
Name:GERST, BARRY DONALD (DDS)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:DONALD
Last Name:GERST
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 1:3909 W 48TH ST
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55424-1216
Mailing Address - Country:US
Mailing Address - Phone:952-922-5151
Mailing Address - Fax:
Practice Address - Street 1:2701 NICOLLET AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55408-1631
Practice Address - Country:US
Practice Address - Phone:612-874-7674
Practice Address - Fax:612-874-1117
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN78801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice