Individual
TODD ALAN GEREB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5120 BALTIMORE DR, SUITE D, LA MESA, CA 91941
(619) 466-0123
(619) 466-1276
Mailing address
5120 BALTIMORE DR, SUITE D, LA MESA, CA 91941
(619) 466-0123
(619) 466-1276
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
40153
CA
Other
Enumeration date
08/22/2007
Last updated
08/22/2007
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