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General NPI Number Information
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NPI Number | 1922158641
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Entity Type | Organization
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Legal Business Name | GENTLE DENTAL CENTER
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 06/26/2008
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Provider Practice Location Address
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Address Line | 416 W WALNUT ST SUITE C
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City | DANVILLE
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State | KY
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Zip | 40422-1836
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Country | US
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Telephone | 859-236-6181
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Fax | 859-236-5435
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Provider Business Mailing Address
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Address Line | 416 W WALNUT ST SUITE C
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City | DANVILLE
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State | KY
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Zip | 40422-1836
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Country | US
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Telephone | 859-236-6181
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Fax | 859-236-5435
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Authorized Official
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Title or Position | FINANCIAL COORDINATOR
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Name | LESLIE D. DARLAND
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Credential |
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Telephone | 859-236-6181
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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 | 6456
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License Number State | KY
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