Individual
DR. MACARIO MELVIN GENTILE III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2135 E UNIVERSITY DR, STE 115, MESA, AZ 85213-8335
(480) 969-6762
(480) 833-5739
Mailing address
2135 E UNIVERSITY DR, STE 115, MESA, AZ 85213-8335
(480) 969-6762
(480) 833-5739
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1991
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0127770
BLUE/BLUE SHIELD
AZ
01
—
0762858
UNITED CONCORDIA
PA
01
—
1991
DELTA DENTAL
AZ
Enumeration date
05/24/2005
Last updated
09/24/2007
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