Individual
DMITRY GERBER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
408 GRAND ST, NEW YORK, NY 10002-4702
(212) 460-5122
Mailing address
408 GRAND ST, NEW YORK, NY 10002-4702
(212) 460-5122
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
045793
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01539679
—
NY
Enumeration date
10/15/2006
Last updated
07/09/2007
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