Provider Demographics
NPI:1962840520
Name:GERBER, KATHLEEN BAKER (DDS)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:BAKER
Last Name:GERBER
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 1:1575 20TH ST NW
Mailing Address - Street 2:SUITE 102
Mailing Address - City:FARIBAULT
Mailing Address - State:MN
Mailing Address - Zip Code:55021-2930
Mailing Address - Country:US
Mailing Address - Phone:507-334-6433
Mailing Address - Fax:
Practice Address - Street 1:1575 20TH ST NW
Practice Address - Street 2:SUITE 102
Practice Address - City:FARIBAULT
Practice Address - State:MN
Practice Address - Zip Code:55021-2930
Practice Address - Country:US
Practice Address - Phone:507-334-6433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-05
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND13207122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist