Provider Demographics
NPI:1447471818
Name:GEHRS, JAMES L (DDS)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:L
Last Name:GEHRS
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 1:9460 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62223-1713
Mailing Address - Country:US
Mailing Address - Phone:618-397-5121
Mailing Address - Fax:618-397-4699
Practice Address - Street 1:9460 W MAIN ST
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62223-1713
Practice Address - Country:US
Practice Address - Phone:618-397-5121
Practice Address - Fax:618-397-4699
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist