Provider Demographics
NPI:1265712590
Name:SIEGEL GERHARD, CLAIRE F (DDS)
Entity type:Individual
Prefix:DR
First Name:CLAIRE
Middle Name:F
Last Name:SIEGEL GERHARD
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 1:330 S 11TH ST
Mailing Address - Street 2:UNIT 4206
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23219-1925
Mailing Address - Country:US
Mailing Address - Phone:513-673-1478
Mailing Address - Fax:
Practice Address - Street 1:520 N 12TH ST
Practice Address - Street 2:ROOM 224
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-5064
Practice Address - Country:US
Practice Address - Phone:804-828-9363
Practice Address - Fax:804-827-1373
Is Sole Proprietor?:No
Enumeration Date:2011-08-18
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-023457122300000X
VA0442000170122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist