Individual
DR. MICHAEL ALLEN GENTRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1722 S GLENSTONE AVE, SUITE K, SPRINGFIELD, MO 65804-1519
(417) 883-8162
(417) 883-6225
Mailing address
1722 S GLENSTONE AVE, SUITE K, SPRINGFIELD, MO 65804-1519
(417) 883-8162
(417) 883-6225
Taxonomy
Speciality
Code
Description
License number
State
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
—
MO
207NS0135X
Procedural Dermatology Physician
Primary
29675
MO
Other
Enumeration date
07/27/2006
Last updated
07/18/2007
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