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NPI Code Detail

MEDICARE: DON C GILBRETH DMD LTD

MEDICARE: DON C GILBRETH DMD LTD
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
1122300000XDentist0929NV
21223G0001XGeneral Practice Dentistry0929NV

General Provider Information

NPI Number : 1528571106
Entity Type Code : Organization
Provider Name (Legal Business Name) : DON C GILBRETH DMD LTD
Provider Business Mailing Address
First Line : 5785 CENTENNIAL CENTER BLVD STE 180
Second Line :
City : LAS VEGAS
State : NV
Zip : 89149-7110
Country : US
Telephone Number : 702-395-0366
Fax Number : 702-645-7433
Provider Business Practice Location Address
First Line : 5785 CENTENNIAL CENTER BLVD STE 180
Second Line :
City : LAS VEGAS
State : NV
Zip : 89149-7110
Country : US
Telephone Number : 702-395-0366
Fax Number : 702-645-7433
Authorized Official
Title or Position : OWNER
Name : DR. DON C GILBRETH
Credential : DMD
Telephone Number : 702-395-0366
Provider Enumeration Date : 11/06/2017
Last Update Date : 11/06/2017

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Directions to “DON C GILBRETH DMD LTD ” Practice Location

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