Provider Demographics
NPI:1881701241
Name:GAJEWSKI, MERRY ANNA (DDS)
Entity type:Individual
Prefix:DR
First Name:MERRY
Middle Name:ANNA
Last Name:GAJEWSKI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:MERRY
Other - Middle Name:ANNA
Other - Last Name:RABOTSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:E7494 LARS HILL RD
Mailing Address - Street 2:
Mailing Address - City:WESTBY
Mailing Address - State:WI
Mailing Address - Zip Code:54667
Mailing Address - Country:US
Mailing Address - Phone:608-634-3998
Mailing Address - Fax:
Practice Address - Street 1:100 MELBY ST
Practice Address - Street 2:
Practice Address - City:WESTBY
Practice Address - State:WI
Practice Address - Zip Code:54667
Practice Address - Country:US
Practice Address - Phone:608-634-3128
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4093122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist