# GENTLE FAMILY DENTISTRY, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538233457
- **Authorized official:** DR. LYNN C. WENTZ DDS (PRESIDENT)
- **Authorized official phone:** (208) 476-4315

## Contact information

- **Practice address:** 1265 AHSAHKA RD, OROFINO, ID 83544-9025
- **Practice address phone:** (208) 476-4315
- **Practice address fax:** (208) 476-4353
- **Mailing address:** PO BOX 748, OROFINO, ID 83544-0748
- **Mailing address phone:** (208) 476-4315
- **Mailing address fax:** (208) 476-4353

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | D2073 | ID | Yes |
| 1223G0001X | General Practice Dentistry | D3474 | ID | — |

## Other

- **Enumeration date:** 11/20/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 10029033 | REGENCE BLUE SHIELD | ID |
| 01 | — | 62073 | WASHINGTON DENTAL SERVICE | ID |
| 01 | — | 723020 | UNITED CONCORDIA | ID |
| 01 | — | I 93452 | REGENCE BLUE SHIELD | ID |
| 01 | — | I90841 | REGENCE BLUE SHIELD | ID |