Individual
ELIZABETH GENTRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1610 PACE ST UNIT 100, LONGMONT, CO 80504-2239
(033) 772-9966
Mailing address
1610 PACE ST UNIT 100, LONGMONT, CO 80504-2239
(303) 772-9966
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
00205099
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/24/2021
Last updated
10/26/2023
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