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Provider Information for 1376927053

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DR. GARRETT GLYNN GENTLING D.D.S.

Gender: MALE

Individual NPI: 1376927053

Calendar   Last Updated:  2020-03-19
  Certification Date:  2020-03-19

Details

Name Value
NPI 1376927053
Enumeration Date 2015-07-13
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 1207 N 200TH ST STE 220
SHORELINE, WA 98133-3213
United States

Phone: 206-546-4815 | Fax: 206-546-2375
View Map External Link
Primary Practice Address 1207 N 200TH ST STE 220
SHORELINE, WA 98133-3213
United States

Phone: 206-546-4815 | Fax: 206-546-2375
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Direct Messaging Address info@gentlingsmiles.com Gentling Smiles E-mail 1207 N 200TH ST STE 220
SHORELINE, WA 98133-3213
United States
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 1223G0001X - Dentist General Practice WA DE60687419
No 122300000X - Dentist HI DT 2605