Provider Demographics
NPI:1811098999
Name:GERRETS, THOMAS FERRIS JR (DMD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:FERRIS
Last Name:GERRETS
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:599 STEED RD # A
Mailing Address - Street 2:
Mailing Address - City:RIDGELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39157-1707
Mailing Address - Country:US
Mailing Address - Phone:601-898-9282
Mailing Address - Fax:601-898-3871
Practice Address - Street 1:599 STEED RD # A
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-1707
Practice Address - Country:US
Practice Address - Phone:601-898-9282
Practice Address - Fax:601-898-3871
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSENDO-341-001223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics