| John Herbert Gerstenmaier | |
|
3094 West Market St #260 Fairlawn OH 44333-3626 | |
| (330) 867-5688 | |
| (330) 867-9921 |
| Full Name | John Herbert Gerstenmaier |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 3094 West Market St, Fairlawn, Ohio |
| Authorized Official Name and Position | John Herbert Gerstenmaier (OWNER PRESIDENT) |
| Authorized Official Contact | 3308675688 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| John Herbert Gerstenmaier 3094 West Market St #260 Fairlawn OH 44333-3626 Ph: (330) 867-5688 | John Herbert Gerstenmaier 3094 West Market St #260 Fairlawn OH 44333-3626 Ph: (330) 867-5688 |
| NPI Number | 1568636660 |
|---|---|
| Provider Enumeration Date | 04/18/2008 |
| Last Update Date | 04/18/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568636660 | NPI | - | NPPES |
| 0273814 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 30014537 (Ohio) | Primary |
| 1223P0221X | Dentist - Pediatric Dentistry | 2901010057 (Michigan) | Secondary |
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