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General NPI Number Information
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NPI Number | 1629153069
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Entity Type | Organization
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Legal Business Name | R. SCOTT GAMBLE, D.M.D., P.C.
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2740 BATTLES RD
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City | ASHFORD
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State | AL
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Zip | 36312
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Country | US
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Telephone | 334-899-8033
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Fax | 334-899-8165
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Provider Business Mailing Address
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Address Line | PO BOX 408
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City | ASHFORD
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State | AL
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Zip | 36312-0408
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Country | US
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Telephone | 334-899-8033
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Fax | 334-899-8165
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBERT S GAMBLE
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Credential | D.M.D.
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Telephone | 334-899-8033
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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 | 4698
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License Number State | AL
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