Individual
DR. JOHN L. GENTUSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
0 GOVERNORS AVE, SUITE 1, MEDFORD, MA 02155-3025
(781) 395-5629
(781) 395-5863
Mailing address
0 GOVERNORS AVE, SUITE 1, MEDFORD, MA 02155-3025
(781) 395-5629
(781) 395-5863
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
15627
MA
Other
Enumeration date
05/12/2006
Last updated
07/11/2007
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