Provider Demographics
NPI:1417133752
Name:GAMBILL, JAMES MARTIN (DDS)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:MARTIN
Last Name:GAMBILL
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 1:1617 S HAWTHORNE RD
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-4127
Mailing Address - Country:US
Mailing Address - Phone:336-768-1740
Mailing Address - Fax:336-768-1778
Practice Address - Street 1:1617 S HAWTHORNE RD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-4127
Practice Address - Country:US
Practice Address - Phone:336-768-1740
Practice Address - Fax:336-768-1778
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-17
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC52911223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics