| Gary R. Jernberg, D.D.S., M.S.D. | |
|
99 Navaho Ave Suite 102 Mankato MN 56001-4876 | |
| (507) 345-7537 | |
| (507) 345-7538 |
| Full Name | Gary R. Jernberg, D.D.S., M.S.D. |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 99 Navaho Ave, Mankato, Minnesota |
| Authorized Official Name and Position | Gary Robert Jernberg (PERIODONTIST) |
| Authorized Official Contact | 5073457537 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gary R. Jernberg, D.D.S., M.S.D. 99 Navaho Ave Suite 102 Mankato MN 56001-4876 Ph: (507) 345-7537 | Gary R. Jernberg, D.D.S., M.S.D. 99 Navaho Ave Suite 102 Mankato MN 56001-4876 Ph: (507) 345-7537 |
| NPI Number | 1851510952 |
|---|---|
| Provider Enumeration Date | 04/25/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851510952 | NPI | - | NPPES |
| 1B004JE | Other | MN | BCBS OF MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | (NU) | Primary |
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