Provider Demographics
NPI:1275948614
Name:GABRIEL, SHYLAH (DMD)
Entity Type:Individual
Prefix:
First Name:SHYLAH
Middle Name:
Last Name:GABRIEL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 S ALMA SCHOOL RD STE 9
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-7633
Mailing Address - Country:US
Mailing Address - Phone:480-857-4900
Mailing Address - Fax:480-857-4904
Practice Address - Street 1:290 S ALMA SCHOOL RD STE 9
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-7633
Practice Address - Country:US
Practice Address - Phone:480-857-4900
Practice Address - Fax:480-857-4904
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-24
Last Update Date:2016-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD0089461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice