Individual
JONATHAN J GERIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1305 21ST AVE, FAIRBANKS, AK 99701-6084
(907) 456-5665
(907) 456-1753
Mailing address
1305 21ST AVE, FAIRBANKS, AK 99701-6084
(907) 456-5665
(907) 456-1753
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1350
AK
122300000X
Dentist
24544
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1601351
—
AK
Enumeration date
06/17/2009
Last updated
05/15/2014
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