Individual
DR. JEREL D GUTIERREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
200 CARMICHAEL WAY STE 612, CHESAPEAKE, VA 23322-2489
(757) 204-7210
(757) 204-7213
Mailing address
200 CARMICHAEL WAY STE 612, CHESAPEAKE, VA 23322-2489
(757) 204-7210
(757) 204-7213
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401411448
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11448
DELTA
VA
01
—
1865742
UNITED CONCORDIA
—
01
—
238989
ANTEM BC & BS OF VA
VA
Enumeration date
02/26/2007
Last updated
01/24/2017
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