Organization
GENTLE DENTISTRY OF LANCASTER, PLLC
Active
Parent organization
GENTLE DENTISTRY OF LANCASTER, PLLC
Other names
EastSide Dental Medicine
Organization subpart
Yes
Provider details
NPI number
Legal business name
GENTLE DENTISTRY OF LANCASTER, PLLC
Authorized official
CASSANDRA PETERSEN (CREDENTIALING TEAM LEAD)
(217) 540-8972
Entity
Organization
Contact information
Practice address
595 MADISON AVE FL 27, NEW YORK, NY 10022-1649
(212) 758-9498
Mailing address
595 MADISON AVE FL 27, NEW YORK, NY 10022-1649
(212) 758-9498
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
02/26/2018
Last updated
02/26/2018
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