MEDICARE: GENTLE DENTAL CARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1124368220
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GENTLE DENTAL CARE

Provider Business Mailing Address
First Line	:	4105 W SPRING CREEK PKWY
Second Line	:	SUITE #704
City	:	PLANO
State	:	TX
Zip	:	75024-5283
Country	:	US
Telephone Number	:	972-596-3300
Fax Number	:	972-596-3327

Provider Business Practice Location Address
First Line	:	4105 W SPRING CREEK PKWY
Second Line	:	704
City	:	PLANO
State	:	TX
Zip	:	75024-5283
Country	:	US
Telephone Number	:	972-596-3300
Fax Number	:	972-596-3327

Authorized Official
Title or Position	:	OWNER
Name	:	DR. SANJAY V RAO
Credential	:	DDS
Telephone Number	:	972-596-3300

Provider Enumeration Date	:	02/26/2013
Last Update Date	:	02/26/2013

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Directions to “GENTLE DENTAL CARE ” Practice Location

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