Individual
PHILIP WILLIAM GERVAIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2005 W PINE ST, SANDPOINT, ID 83864-9324
(208) 263-8535
(208) 265-2365
Mailing address
2005 W PINE ST, SANDPOINT, ID 83864-9324
(208) 263-8535
(208) 265-2365
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D1748
ID
Other
Enumeration date
10/03/2006
Last updated
07/08/2007
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