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Individual
DR. JOHN ROBERT GERVASI
Active
Individual
DR. JOHN ROBERT GERVASI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
12773533-9922
UT
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/11/2021
Last updated
07/26/2022
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