Organization

Gary R. Jernberg, D.D.S., M.S.D.

Periodontist in Mankato, MN(View on Map)

Legal Business Name

Gary R. Jernberg, D.D.S., M.S.D.

NPI Number

1851510952

NPI Type

Organization

Enumeration Date

04/25/2007

Specialties

(Taxonomies)

Code

1223P0300X

Primary Taxonomy

Yes

Contact
Information

Purpose

Mailing
Location

Address

99 NAVAHO AVE
99 NAVAHO AVE

City

Mankato
Mankato

State

MN
MN

Postal Code

56001-4876
56001-4876

Country

US
US

Telephone Number

(507) 345-7537
(507) 345-7537

Authorized Official

Name

Dr. Gary Jernberg

Title or Position

PERIODONTIST

Telephone Number

(507) 345-7537

Identifiers

Identifier

1B004JE

Identifier State

MN

Identifier Issuer

BCBS OF MN

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 08/22/2020

Provider Address

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Organization

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