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Individual

ALFRED RAYMOND GERNERT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD MS ORTHODONTICS

Contact information

Practice address
604 CRYSTAL PLACE, SITE 2A, LAGRANGE, KY 40031
(502) 222-6202
Mailing address
604 CRYSTAL PLACE, SUITE 2A, LAGRANGE, KY 40031
(502) 222-6202

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3961
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0008607
KY
Enumeration date
11/08/2005
Last updated
08/17/2015
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