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General NPI Number Information
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NPI Number | 1205305000
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Entity Type | Organization
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Legal Business Name | KARUN GABA DMD LLC
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Dates
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Enumeration Date | 11/21/2018
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Last Update Date | 01/07/2019
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Provider Practice Location Address
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Address Line | 10320 W MCDOWELL RD STE A1001
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City | AVONDALE
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State | AZ
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Zip | 85392-4865
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Country | US
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Telephone | 623-242-6001
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Fax | 623-242-6006
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Provider Business Mailing Address
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Address Line | 15288 W BROOKSIDE LN STE 131
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City | SURPRISE
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State | AZ
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Zip | 85374-3990
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Country | US
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Telephone | 623-251-4346
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Fax | 623-251-4767
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Authorized Official
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Title or Position | OWNER
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Name | DR. KARUN GABA
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Credential | DMD
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Telephone | 602-399-9663
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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