Provider Demographics
NPI:1417316175
Name:ORTHO
Entity Type:Organization
Organization Name:ORTHO
Other - Org Name:ACCESS HEALTH DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:GUBLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:702-322-2200
Mailing Address - Street 1:6669 SMOKE RANCH RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89108-8419
Mailing Address - Country:US
Mailing Address - Phone:702-322-2200
Mailing Address - Fax:702-761-4367
Practice Address - Street 1:6669 SMOKE RANCH RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89108-8419
Practice Address - Country:US
Practice Address - Phone:702-322-2200
Practice Address - Fax:702-761-4367
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHAD N GUBLER DDS, CASINO DIRECT LTD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-02-23
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV33311223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty