Individual provider · Type 1 NPI

John Robert Gervasi, DDS

Student in an Organized Health Care Education/Training Program · Orem, UT

NPI number 1255909701 Active

Practice location

1834 S State St
Orem, UT 84097-8109

Call (801) 302-2600 Map

Mailing address

1248 E Sophomore Cir
Salt Lake City, UT 84117-4161

Specialties and licenses

TaxonomyCodeLicense
General Practice Dentistry 1223G0001X12773533-9922 (UT)
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1255909701

John Robert Gervasi, DDS's National Provider Identifier is 1255909701, issued on Jun 11, 2021. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Orem, UT. The record was last updated on Jul 26, 2022.