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NPI Code Detail

MEDICARE: DR. RICHARD HENRY GENTZLER III DDS

MEDICARE:  DR. RICHARD HENRY GENTZLER III DDS
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
11223P0221XPediatric Dentistry7882TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1801903067
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RICHARD HENRY GENTZLER III DDS
Provider Business Mailing Address
First Line : 106 BABB DR
Second Line :
City : LEBANON
State : TN
Zip : 37087-2506
Country : US
Telephone Number : 615-443-3633
Fax Number :
Provider Business Practice Location Address
First Line : 106 BABB DR
Second Line :
City : LEBANON
State : TN
Zip : 37087-2506
Country : US
Telephone Number : 615-443-3633
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2006
Last Update Date : 06/30/2009

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