Individual
COLBY J GERTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
9990 W 190TH ST STE D, MOKENA, IL 60448-8189
(708) 479-9797
Mailing address
9990 W 190TH ST STE D, MOKENA, IL 60448-8189
(708) 479-9797
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019.032596
IL
Other
Enumeration date
07/02/2020
Last updated
07/02/2020
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