Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 10957 | MN |
NPI | 1205903713 |
---|---|
Provider Name | Dr. John Gerstner |
First Address | Minneapolis, MN 55410-1412 |
Second Address | Golden Valley, MN 55427-4563 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2006 |
Last Update Date | 08/07/2007 |