Individual
CARLA GEHA I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9 CUSUMANO PROFESSIONAL PLAZA DR, MOUNT VERNON, IL 62864-6736
(618) 315-6213
(618) 315-6214
Mailing address
PO BOX 1003, MOUNT VERNON, IL 62864-0021
(850) 345-8915
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019028108
IL
Other
Enumeration date
02/21/2007
Last updated
01/04/2012
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