Provider Demographics
NPI:1730587973
Name:GENTLE FAMILY DENTISTRY
Entity type:Organization
Organization Name:GENTLE FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NEAL
Authorized Official - Middle Name:H
Authorized Official - Last Name:LOCKER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:814-693-6777
Mailing Address - Street 1:510 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:DUNCANSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16635-1414
Mailing Address - Country:US
Mailing Address - Phone:814-693-6777
Mailing Address - Fax:814-693-6647
Practice Address - Street 1:510 3RD AVE
Practice Address - Street 2:
Practice Address - City:DUNCANSVILLE
Practice Address - State:PA
Practice Address - Zip Code:16635-1414
Practice Address - Country:US
Practice Address - Phone:814-693-6777
Practice Address - Fax:814-693-6647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-19
Last Update Date:2014-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDS025561L261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental