Provider Demographics
NPI:1417216078
Name:GENTLE TOUCH DENTISTRY
Entity Type:Organization
Organization Name:GENTLE TOUCH DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAHMORESI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-698-4698
Mailing Address - Street 1:500 E. CENTRAL TEXAS EXPWAY
Mailing Address - Street 2:
Mailing Address - City:HARKER HEIGHTS
Mailing Address - State:TX
Mailing Address - Zip Code:76548
Mailing Address - Country:US
Mailing Address - Phone:254-698-4698
Mailing Address - Fax:254-698-3590
Practice Address - Street 1:500 E. CENTRAL TEXAS EXPWAY
Practice Address - Street 2:
Practice Address - City:HARKER HEIGHTS
Practice Address - State:TX
Practice Address - Zip Code:76548
Practice Address - Country:US
Practice Address - Phone:254-698-4698
Practice Address - Fax:254-698-3590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-16
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX200111223G0001X
TX204391223G0001X
TX239661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty