# GENTLE DENTAL GRATIOT AVE PLLC

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

## Provider details

- **NPI number:** 1811012826
- **Authorized official:** VICTORIA JOHNSON (CRO)
- **Authorized official phone:** (941) 444-0558

## Contact information

- **Practice address:** 11180 GRATIOT AVE, DETROIT, MI 48213-1363
- **Practice address phone:** (313) 245-1780
- **Mailing address:** 11180 GRATIOT AVE, DETROIT, MI 48213-1363

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 03/20/2007
- **Last updated:** 07/22/2026