Healthcare Provider Details

I. General information

NPI: 1922171768
Provider Name (Legal Business Name): WILLIAM H GAMBLE DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: WILLIAM H GAMBLE DDS

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

570 THOMSON HWY
WARRENTON GA
30828-9007
US

IV. Provider business mailing address

570 THOMSON HWY
WARRENTON GA
30828-9007
US

V. Phone/Fax

Practice location:
  • Phone: 706-465-3386
  • Fax: 706-465-0608
Mailing address:
  • Phone: 706-465-3386
  • Fax: 706-465-0608

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: