Provider Demographics
NPI:1972877942
Name:GENTLE FAMILY AND COSMETIC DENTISTRY PA
Entity type:Organization
Organization Name:GENTLE FAMILY AND COSMETIC DENTISTRY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEMA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUPTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-618-5300
Mailing Address - Street 1:5575 WARREN PKWAY
Mailing Address - Street 2:STE 210
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-4066
Mailing Address - Country:US
Mailing Address - Phone:214-618-5300
Mailing Address - Fax:214-618-3984
Practice Address - Street 1:5575 WARREN PKWY
Practice Address - Street 2:STE 210
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-4066
Practice Address - Country:US
Practice Address - Phone:214-618-5300
Practice Address - Fax:214-618-3984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-08
Last Update Date:2012-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX206991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty