Provider Demographics
NPI:1730237330
Name:GENTILE, STEPHEN E (DMD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:E
Last Name:GENTILE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1321 RIVERSIDE PARKWAY
Mailing Address - Street 2:D 4
Mailing Address - City:BELCAMP
Mailing Address - State:MD
Mailing Address - Zip Code:21017
Mailing Address - Country:US
Mailing Address - Phone:410-272-7800
Mailing Address - Fax:410-272-7800
Practice Address - Street 1:1321 RIVERSIDE PKWY
Practice Address - Street 2:D 4
Practice Address - City:BELCAMP
Practice Address - State:MD
Practice Address - Zip Code:21017
Practice Address - Country:US
Practice Address - Phone:410-272-7800
Practice Address - Fax:410-272-7800
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDMD104731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice