Provider Demographics
NPI:1528156338
Name:GABRIEL, EMERENCIANA GARCIA (DMD)
Entity type:Individual
Prefix:DR
First Name:EMERENCIANA
Middle Name:GARCIA
Last Name:GABRIEL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 E BROADWAY
Mailing Address - Street 2:SUITE NUMBER 102
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-5113
Mailing Address - Country:US
Mailing Address - Phone:562-624-0990
Mailing Address - Fax:562-624-0950
Practice Address - Street 1:615 E BROADWAY
Practice Address - Street 2:SUITE NUMBER 102
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90802-5113
Practice Address - Country:US
Practice Address - Phone:562-624-0990
Practice Address - Fax:562-624-0950
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA399581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice