Individual
DR. MARK PHILLIP GERALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
3277 S CRATER RD, PETERSBURG, VA 23805-9285
(804) 732-5776
(804) 732-5782
Mailing address
3277 S CRATER RD, PETERSBURG, VA 23805-9285
(804) 732-5776
(804) 732-5782
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401413239
VA
Other
Enumeration date
06/23/2011
Last updated
06/23/2011
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