Individual
GORDON GENTA
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2600 E SOUTHERN AVE, STE J-2, TEMPE, AZ 85282-7610
(480) 345-0964
(480) 820-3309
Mailing address
2600 E SOUTHERN AVE, STE J-2, TEMPE, AZ 85282-7610
(480) 345-0964
(480) 820-3309
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
15529
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
249880
—
AZ
Enumeration date
01/25/2006
Last updated
07/08/2007
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