Provider Demographics
NPI:1194861773
Name:GAMBELLA, DANIEL STEVEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:STEVEN
Last Name:GAMBELLA
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 1:900 MERCHANTS CONCOURSE
Mailing Address - Street 2:SUITE LL8
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-5142
Mailing Address - Country:US
Mailing Address - Phone:516-683-9100
Mailing Address - Fax:516-683-1232
Practice Address - Street 1:900 MERCHANTS CONCOURSE
Practice Address - Street 2:SUITELL8 DENTAL WORLD
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-5142
Practice Address - Country:US
Practice Address - Phone:516-683-9100
Practice Address - Fax:516-683-1232
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0439671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice