Provider Demographics
NPI:1043319478
Name:GENTLE FAMILY DENTAL CARE DR AUST AND SHAVER LLC
Entity type:Organization
Organization Name:GENTLE FAMILY DENTAL CARE DR AUST AND SHAVER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:D
Authorized Official - Last Name:AUST
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:614-272-0011
Mailing Address - Street 1:1444 W MOUND ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43223
Mailing Address - Country:US
Mailing Address - Phone:614-272-0011
Mailing Address - Fax:614-272-0147
Practice Address - Street 1:1444 W MOUND ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43223
Practice Address - Country:US
Practice Address - Phone:614-272-0011
Practice Address - Fax:614-272-0147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH17894122300000X
OH21406122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty