Provider Demographics
NPI:1003038910
Name:GENTLE TOUCH DENTAL GROUP
Entity Type:Organization
Organization Name:GENTLE TOUCH DENTAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:FINGEROV
Authorized Official - Suffix:
Authorized Official - Credentials:DOCTOR
Authorized Official - Phone:818-882-0009
Mailing Address - Street 1:8363 RESEDA BLVD
Mailing Address - Street 2:11
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324-4623
Mailing Address - Country:US
Mailing Address - Phone:818-882-0009
Mailing Address - Fax:818-882-0011
Practice Address - Street 1:8363 RESEDA BLVD
Practice Address - Street 2:11
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324-4623
Practice Address - Country:US
Practice Address - Phone:818-882-0009
Practice Address - Fax:818-882-0011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA458581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty