Provider Demographics
NPI:1396965141
Name:GERBER, C RICHARD (DDS)
Entity type:Individual
Prefix:DR
First Name:C
Middle Name:RICHARD
Last Name:GERBER
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 1:314 BARKWILL STREET
Mailing Address - Street 2:
Mailing Address - City:ST. MARYS
Mailing Address - State:WV
Mailing Address - Zip Code:26170
Mailing Address - Country:US
Mailing Address - Phone:304-684-2204
Mailing Address - Fax:
Practice Address - Street 1:314 BARKWILL STREET
Practice Address - Street 2:
Practice Address - City:ST. MARYS
Practice Address - State:WV
Practice Address - Zip Code:26170
Practice Address - Country:US
Practice Address - Phone:304-684-2204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV26951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice