MEDICARE: DR. KAY N GUBLER DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	635	NV

General Provider Information

NPI Number	:	1013029164
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAY N GUBLER DDS

Provider Business Mailing Address
First Line	:	2430 E HARMON AVE STE 1
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121
Country	:	US
Telephone Number	:	702-796-0095
Fax Number	:	702-796-8863

Provider Business Practice Location Address
First Line	:	2430 E HARMON AVE STE 1
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121
Country	:	US
Telephone Number	:	702-796-0095
Fax Number	:	702-796-8863

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	07/08/2007

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