Provider Demographics
NPI:1841255759
Name:DENT, GARY H (MD)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:H
Last Name:DENT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 EISENHOWER DR STE 1305
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-1607
Mailing Address - Country:US
Mailing Address - Phone:912-764-2455
Mailing Address - Fax:912-764-7522
Practice Address - Street 1:340 EISENHOWER DR STE 1305
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-1607
Practice Address - Country:US
Practice Address - Phone:912-304-5772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-20
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA055932085R0204X
GA0559372085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA055937OtherLICENSE
GA055937OtherLICENSE
GAI45305Medicare UPIN