Provider Demographics
NPI:1265456651
Name:GILBERT, WILLIAM D (DDS)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:D
Last Name:GILBERT
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 1:7005 BOARDWALK DR STE 100
Mailing Address - Street 2:
Mailing Address - City:GRANITE BAY
Mailing Address - State:CA
Mailing Address - Zip Code:95746-9200
Mailing Address - Country:US
Mailing Address - Phone:916-791-4646
Mailing Address - Fax:916-791-5247
Practice Address - Street 1:7005 BOARDWALK DR STE 100
Practice Address - Street 2:
Practice Address - City:GRANITE BAY
Practice Address - State:CA
Practice Address - Zip Code:95746-9200
Practice Address - Country:US
Practice Address - Phone:916-791-4646
Practice Address - Fax:916-791-5247
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA337681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice