Provider Demographics
NPI:1083705594
Name:CHAMBLIN, GABRIEL ALPHONSE V (DMD)
Entity Type:Individual
Prefix:DR
First Name:GABRIEL
Middle Name:ALPHONSE
Last Name:CHAMBLIN
Suffix:V
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6450 US HIGHWAY 90
Mailing Address - Street 2:SUITE D
Mailing Address - City:SPANISH FORT
Mailing Address - State:AL
Mailing Address - Zip Code:36527-9405
Mailing Address - Country:US
Mailing Address - Phone:251-626-7675
Mailing Address - Fax:251-626-8194
Practice Address - Street 1:6450 US HIGHWAY 90
Practice Address - Street 2:SUITE D
Practice Address - City:SPANISH FORT
Practice Address - State:AL
Practice Address - Zip Code:36527-9405
Practice Address - Country:US
Practice Address - Phone:251-626-7675
Practice Address - Fax:251-626-8194
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3925122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist