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Organization

GENTLE CARE DENTISTRY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CHARLES W. CHURCH DDS (OWNER)
(321) 453-7047
Entity
Organization

Contact information

Practice address
400 E MERRITT AVE, SUITE B, MERRITT ISLAND, FL 32953-3434
(321) 453-7047
(321) 453-4449
Mailing address
400 E MERRITT AVE, SUITE B, MERRITT ISLAND, FL 32953-3434
(321) 453-7047
(321) 453-4449

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN-4541
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
DN-4541
STATE OF FL BOARD OF DENT
FL
Enumeration date
02/05/2007
Last updated
08/22/2020
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