Individual
KASEY BETH GENTILIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
116 HILLS PLZ, CHARLESTON, WV 25387-2438
(304) 720-4466
(304) 720-4813
Mailing address
116 HILLS PLZ, CHARLESTON, WV 25387-2438
(304) 720-4466
(304) 720-4813
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3993
WV
122300000X
Dentist
DS039139
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
WV6461A
MEDICARE PTAN
WV
Enumeration date
06/13/2012
Last updated
08/02/2019
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