Provider Demographics
NPI:1487006094
Name:SEARLE, GINA-MARIE (DDS)
Entity type:Individual
Prefix:DR
First Name:GINA-MARIE
Middle Name:
Last Name:SEARLE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1232 BERGEN PKWY
Mailing Address - Street 2:
Mailing Address - City:EVERGREEN
Mailing Address - State:CO
Mailing Address - Zip Code:80439-9573
Mailing Address - Country:US
Mailing Address - Phone:303-674-6070
Mailing Address - Fax:
Practice Address - Street 1:1232 BERGEN PKWY
Practice Address - Street 2:
Practice Address - City:EVERGREEN
Practice Address - State:CO
Practice Address - Zip Code:80439-9573
Practice Address - Country:US
Practice Address - Phone:303-674-6070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-07
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.002028961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice