# GENTLE DENTAL

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

## Provider details

- **NPI number:** 1740310630
- **Authorized official:** VANESSA PHAN DMD (DENTIST)
- **Authorized official phone:** (404) 499-2216

## Contact information

- **Practice address:** 3595 HILL ST., CLARKSTON, GA 30021
- **Practice address phone:** (404) 499-2216
- **Mailing address:** 3595 HILL ST., CLARKSTON, GA 30021
- **Mailing address phone:** (404) 499-2216

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | DN012128 | GA | Yes |

## Other

- **Enumeration date:** 03/07/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00882824D | — | GA |