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General NPI Number Information
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NPI Number | 1003038910
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Entity Type | Organization
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Legal Business Name | GENTLE TOUCH DENTAL GROUP
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 01/23/2008
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Provider Practice Location Address
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Address Line | 8363 RESEDA BLVD 11
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City | NORTHRIDGE
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State | CA
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Zip | 91324-4623
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Country | US
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Telephone | 818-882-0009
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Fax | 818-882-0011
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Provider Business Mailing Address
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Address Line | 8363 RESEDA BLVD 11
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City | NORTHRIDGE
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State | CA
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Zip | 91324-4623
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Country | US
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Telephone | 818-882-0009
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Fax | 818-882-0011
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Authorized Official
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Title or Position | OWNER
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Name | IRINA FINGEROV
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Credential | DOCTOR
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Telephone | 818-882-0009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 45858
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License Number State | CA
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