Provider Demographics
NPI:1851598601
Name:GERLOCK, SHERRY ROCHELLE (RDH)
Entity Type:Individual
Prefix:MS
First Name:SHERRY
Middle Name:ROCHELLE
Last Name:GERLOCK
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70786 OXFORD RD
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:IA
Mailing Address - Zip Code:50843-8131
Mailing Address - Country:US
Mailing Address - Phone:712-774-2390
Mailing Address - Fax:
Practice Address - Street 1:2602 J ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68107-1643
Practice Address - Country:US
Practice Address - Phone:402-733-1325
Practice Address - Fax:402-733-3487
Is Sole Proprietor?:No
Enumeration Date:2007-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1728124Q00000X
IA3086124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist