Gerald, Mark Phillip

Gerald, Mark Phillip is an individual health care provider with primary practice located at 3277 S Crater Rd , Petersburg VA 23805-9285. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Gerald, Mark Phillip can be contacted via phone (804) 732-5776.

Contact Information

Primary practice address
3277 S Crater Rd Petersburg VA 23805-9285
Phone: (804) 732-5776
Fax: (804) 732-5782
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 0401413239 Virginia

Profile Details

NPI number 1265728612
LBN Legal business name Gerald, Mark Phillip
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2011
Last updated Jun 23rd, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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