Provider Demographics
NPI:1396050431
Name:GERRARD, DEVIN MASON (DDS)
Entity type:Individual
Prefix:DR
First Name:DEVIN
Middle Name:MASON
Last Name:GERRARD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 E 500 S
Mailing Address - Street 2:
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010-4979
Mailing Address - Country:US
Mailing Address - Phone:801-295-5796
Mailing Address - Fax:
Practice Address - Street 1:311 E 500 S
Practice Address - Street 2:
Practice Address - City:BOUNTIFUL
Practice Address - State:UT
Practice Address - Zip Code:84010-4979
Practice Address - Country:US
Practice Address - Phone:801-295-5796
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-13
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7376678-99221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice