Provider Demographics
NPI:1932716859
Name:GENTLE DENTISTRY INC
Entity Type:Organization
Organization Name:GENTLE DENTISTRY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAVI
Authorized Official - Middle Name:
Authorized Official - Last Name:DOCTOR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:817-274-8667
Mailing Address - Street 1:1810 S BOWEN RD STE A
Mailing Address - Street 2:
Mailing Address - City:PANTEGO
Mailing Address - State:TX
Mailing Address - Zip Code:76013-3340
Mailing Address - Country:US
Mailing Address - Phone:817-274-8667
Mailing Address - Fax:
Practice Address - Street 1:1810 S BOWEN RD STE A
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76013-3340
Practice Address - Country:US
Practice Address - Phone:817-274-8667
Practice Address - Fax:817-328-2404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-24
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty