Individual
DR. MARK A GENTNER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
5556 METROPOLITAN PARKWAY, SUITE B, STERLING HEIGHTS, MI 48310
(586) 939-5980
(586) 939-3409
Mailing address
62843 BROADMOOR CIRCLE, WASHINGTON, MI 48094
(586) 786-5841
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
13458
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
432635
UNITED CONCORDIA PROVIDER
MI
Enumeration date
05/15/2006
Last updated
07/08/2007
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