Organization
GENTLE DENTAL OREGON LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE COLE (INSURANCE DIRECTOR)
(727) 726-1611
Entity
Organization
Contact information
Practice address
1419 W OREGON AVE, PHILADELPHIA, PA 19145-4926
(215) 469-0220
(215) 551-0488
Mailing address
1419 W OREGON AVE, PHILADELPHIA, PA 19145-4926
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
03/19/2007
Last updated
06/27/2011
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