Provider Demographics
NPI:1376948422
Name:GENTLE TOUCH DENTAL HYGIENE LLC
Entity Type:Organization
Organization Name:GENTLE TOUCH DENTAL HYGIENE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTAL HYGIENIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:LESLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HARBISON
Authorized Official - Suffix:
Authorized Official - Credentials:RDH
Authorized Official - Phone:503-347-1849
Mailing Address - Street 1:52428 SW JOBIN LN
Mailing Address - Street 2:
Mailing Address - City:SCAPPOOSE
Mailing Address - State:OR
Mailing Address - Zip Code:97056-3506
Mailing Address - Country:US
Mailing Address - Phone:503-347-1849
Mailing Address - Fax:
Practice Address - Street 1:52428 SW JOBIN LN
Practice Address - Street 2:
Practice Address - City:SCAPPOOSE
Practice Address - State:OR
Practice Address - Zip Code:97056-3506
Practice Address - Country:US
Practice Address - Phone:503-347-1849
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-31
Last Update Date:2014-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORH4203124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes124Q00000XDental ProvidersDental HygienistGroup - Single Specialty