Provider Demographics
NPI:1982818472
Name:GENTLE FAMILY DENTISTRY
Entity Type:Organization
Organization Name:GENTLE FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:BOTTONE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:843-884-4486
Mailing Address - Street 1:924 TALL PINE RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-2910
Mailing Address - Country:US
Mailing Address - Phone:843-884-4486
Mailing Address - Fax:843-881-4852
Practice Address - Street 1:924 TALL PINE RD
Practice Address - Street 2:SUITE B
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-2910
Practice Address - Country:US
Practice Address - Phone:843-884-4486
Practice Address - Fax:843-881-4852
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty