Provider Demographics
NPI:1851598874
Name:GENTILE, DONNA (DDS)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:
Last Name:GENTILE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 MERRICK AVE
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-3477
Mailing Address - Country:US
Mailing Address - Phone:516-546-6118
Mailing Address - Fax:
Practice Address - Street 1:31 MERRICK AVE
Practice Address - Street 2:SUITE 220
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-3477
Practice Address - Country:US
Practice Address - Phone:516-546-6118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0515101223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics