Individual
DWAYNE GENTRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
75 MDG DENTAL CLINIC, 697 LOUISIANA, DYESS AFB, TX 77960
(325) 696-2304
Mailing address
7 MDG, 697 LOUISIANA, DYESS AFB, TX 79607
(325) 696-2304
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
83619819922
UT
Other
Enumeration date
08/01/2013
Last updated
07/20/2023
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