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Individual

DR. MOLLY REBECCA GERVICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
21343 ARCHIBALD ROAD, DEERWOOD, MN 56444
(218) 534-3141
(218) 534-3949
Mailing address
PO BOX 385, DEERWOOD, MN 56444
(218) 534-3141
(218) 534-3949

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D13489
MN
1223G0001X
General Practice Dentistry
08637
IA
1223G0001X
General Practice Dentistry
6637-15
WI

Other

Enumeration date
01/03/2011
Last updated
04/19/2019
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