Provider Demographics
NPI:1770184053
Name:GENTLE DENTISTRY OF LANCASTER, PLLC
Entity Type:Organization
Organization Name:GENTLE DENTISTRY OF LANCASTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:TABATHA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEMKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-540-6078
Mailing Address - Street 1:1541 UNION ST
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12309-6001
Mailing Address - Country:US
Mailing Address - Phone:518-332-4786
Mailing Address - Fax:
Practice Address - Street 1:1541 UNION ST
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12309-6001
Practice Address - Country:US
Practice Address - Phone:518-332-4786
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GENTLE DENTISTRY OF LANCASTER, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-11-04
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty