Provider Demographics
NPI:1093929978
Name:GENTLE DENTAL CARE
Entity Type:Organization
Organization Name:GENTLE DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:N
Authorized Official - Last Name:ALTIERI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:207-985-3576
Mailing Address - Street 1:PO BOX 57
Mailing Address - Street 2:
Mailing Address - City:KENNEBUNK
Mailing Address - State:ME
Mailing Address - Zip Code:04043-0057
Mailing Address - Country:US
Mailing Address - Phone:207-985-3576
Mailing Address - Fax:207-467-9125
Practice Address - Street 1:1220 PORTLAND ROAD
Practice Address - Street 2:US RT. 1
Practice Address - City:ARUNDEL
Practice Address - State:ME
Practice Address - Zip Code:04046
Practice Address - Country:US
Practice Address - Phone:207-985-3576
Practice Address - Fax:207-467-9125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME34091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1396771887OtherTYPE 1 NPI