Provider Demographics
NPI:1063500676
Name:GUBLER, SEAN T (DDS)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:T
Last Name:GUBLER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11221 S EASTERN AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-6491
Mailing Address - Country:US
Mailing Address - Phone:702-809-1611
Mailing Address - Fax:702-558-9914
Practice Address - Street 1:11221 S EASTERN AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-6491
Practice Address - Country:US
Practice Address - Phone:702-809-1611
Practice Address - Fax:702-558-9914
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV45001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice