Healthcare Provider Details

I. General information

NPI: 1275542375
Provider Name (Legal Business Name): GABRIEL I. SCHREIBER D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

411 US HIGHWAY 9 STE 4
LANOKA HARBOR NJ
08734-2818
US

IV. Provider business mailing address

411 US HIGHWAY 9 STE 4
LANOKA HARBOR NJ
08734-2818
US

V. Phone/Fax

Practice location:
  • Phone: 609-693-3888
  • Fax: 732-671-6740
Mailing address:
  • Phone: 609-693-3888
  • Fax: 732-671-6740

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number22DI01140800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: