Organization
GENTLE DENTAL, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEFANIE BRESLIN (OFFICE MANAGER)
(319) 393-7000
Entity
Organization
Contact information
Practice address
1515 BLAIRS FERRY RD NE, CEDAR RAPIDS, IA 52402-5804
(319) 393-7000
(319) 294-5814
Mailing address
1515 BLAIRS FERRY RD NE, CEDAR RAPIDS, IA 52402-5804
(319) 393-7000
(319) 294-5814
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05280
WELLMARK BLUECROSS BLUESH
—
01
—
796338
UNITED CONCORDIA
—
05
—
IA11511
—
IA
01
—
V07117
BCBSTX
—
Enumeration date
07/17/2007
Last updated
08/01/2007
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