Provider Demographics
NPI:1013468776
Name:RELIABLE GENTLE CARE DENTAL PLLC
Entity Type:Organization
Organization Name:RELIABLE GENTLE CARE DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:GREG
Authorized Official - Last Name:CARROLL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-980-7777
Mailing Address - Street 1:4618 RIVERSTONE BLVD
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-6141
Mailing Address - Country:US
Mailing Address - Phone:281-980-7777
Mailing Address - Fax:281-741-0765
Practice Address - Street 1:4618 RIVERSTONE BLVD
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-6141
Practice Address - Country:US
Practice Address - Phone:281-980-7777
Practice Address - Fax:281-741-0765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-18
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12946332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies