Provider Demographics
NPI:1841438322
Name:GENTLE FAMILY DENTISTRY, LLC
Entity type:Organization
Organization Name:GENTLE FAMILY DENTISTRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:SCLATER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:410-257-2424
Mailing Address - Street 1:3150 W WARD RD
Mailing Address - Street 2:SUITE 304
Mailing Address - City:DUNKIRK
Mailing Address - State:MD
Mailing Address - Zip Code:20754-3056
Mailing Address - Country:US
Mailing Address - Phone:410-257-2424
Mailing Address - Fax:410-257-2299
Practice Address - Street 1:3150 W WARD RD
Practice Address - Street 2:SUITE 304
Practice Address - City:DUNKIRK
Practice Address - State:MD
Practice Address - Zip Code:20754-3056
Practice Address - Country:US
Practice Address - Phone:410-257-2424
Practice Address - Fax:410-257-2299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-22
Last Update Date:2009-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD54751223G0001X
MD132941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty