Provider Demographics
NPI:1942070883
Name:GENTLE CARE COSMETIC DENTAL PLLC
Entity Type:Organization
Organization Name:GENTLE CARE COSMETIC DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:NADEREH
Authorized Official - Middle Name:
Authorized Official - Last Name:NASR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:240-408-0122
Mailing Address - Street 1:13514 DEERWATER DR
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-2848
Mailing Address - Country:US
Mailing Address - Phone:240-408-0122
Mailing Address - Fax:
Practice Address - Street 1:8 RUSSELL AVE STE 104
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-2962
Practice Address - Country:US
Practice Address - Phone:301-869-2500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-02
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty