Provider Demographics
NPI:1902516735
Name:S. GABRIEL DENTAL CORPORATION
Entity Type:Organization
Organization Name:S. GABRIEL DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:GABRIEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:530-218-8583
Mailing Address - Street 1:2731 S ROSE AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93033-3964
Mailing Address - Country:US
Mailing Address - Phone:805-483-3658
Mailing Address - Fax:
Practice Address - Street 1:2731 S ROSE AVE STE 101
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93033-3964
Practice Address - Country:US
Practice Address - Phone:805-483-3658
Practice Address - Fax:805-483-3696
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-02
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty