Individual
MARISSA LYNN GENTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
10 RICHLAND MEDICAL PARK DR STE A, COLUMBIA, SC 29203-6892
(803) 434-6567
(803) 434-6299
Mailing address
300 E MCBEE AVE STE 300, GREENVILLE, SC 29601-2899
(864) 522-8611
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
11146
SC
1223P0700X
Prosthodontics
Primary
11146
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
NC
Other
Enumeration date
06/23/2022
Last updated
02/16/2026
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