Provider Demographics
NPI:1528571106
Name:DON C GILBRETH DMD LTD
Entity Type:Organization
Organization Name:DON C GILBRETH DMD LTD
Other - Org Name:DON GILBRETH FAMILY & COSMETIC DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DON
Authorized Official - Middle Name:C
Authorized Official - Last Name:GILBRETH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:702-395-0366
Mailing Address - Street 1:5785 CENTENNIAL CENTER BLVD STE 180
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89149-7110
Mailing Address - Country:US
Mailing Address - Phone:702-395-0366
Mailing Address - Fax:702-645-7433
Practice Address - Street 1:5785 CENTENNIAL CENTER BLVD STE 180
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89149-7110
Practice Address - Country:US
Practice Address - Phone:702-395-0366
Practice Address - Fax:702-645-7433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-06
Last Update Date:2017-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0929122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No122300000XDental ProvidersDentistGroup - Single Specialty