Individual
DR. JOHN C GERNETZKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
109 S MADISON ST, EVANSVILLE, WI 53536-1319
(608) 882-4441
(608) 882-4967
Mailing address
109 S MADISON ST, EVANSVILLE, WI 53536-1319
(608) 882-4441
(608) 882-4967
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4078
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33688500
—
WI
Enumeration date
11/19/2005
Last updated
07/08/2007
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