Individual
DR. GLEN S GERDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1811 NW KINGS BLVD, CORVALLIS, OR 97330
(541) 758-0888
(541) 754-6628
Mailing address
1811 NW KINGS BLVD, CORVALLIS, OR 97330
(541) 758-0888
(541) 754-6628
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
D6324
OR
Other
Enumeration date
08/10/2006
Last updated
07/08/2007
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