Individual
SHARONA GERRAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3208 NW FOXTAIL PL, CORVALLIS, OR 97330-3882
(516) 946-7711
Mailing address
3208 NW FOXTAIL PL, CORVALLIS, OR 97330-3882
(516) 946-7711
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
D11197
OR
1223G0001X
General Practice Dentistry
Primary
31574
TX
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
11/03/2014
Last updated
03/24/2020
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