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General NPI Number Information
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NPI Number | 1417316175
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Entity Type | Organization
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Legal Business Name | CHAD GUBLER CASINO DIRECT-ORTHO
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Dates
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Enumeration Date | 02/23/2016
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Last Update Date | 11/27/2024
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Provider Practice Location Address
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Address Line | 3481 E. SUNSET RD. STE 101
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City | LAS VEGAS
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State | NV
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Zip | 89120
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Country | US
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Telephone | 702-322-2180
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Fax | 702-761-4359
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Provider Business Mailing Address
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Address Line | 1701 W. CHARLESTON BLVD. STE 500
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City | LAS VEGAS
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State | NV
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Zip | 89102-2309
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Country | US
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Telephone | 702-322-2200
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Fax | 702-330-5781
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Authorized Official
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Title or Position | OWNER DOCTOR
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Name | DR. CHAD N. GUBLER
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Credential | DDS
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Telephone | 702-349-6350
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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