Provider Demographics
NPI:1568472686
Name:SMOKE RANCH DENTAL GUBLER, DDS LTD
Entity Type:Organization
Organization Name:SMOKE RANCH DENTAL GUBLER, DDS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP, OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:WOLINSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
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:702-869-8031
Mailing Address - Fax:702-658-4327
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:702-869-8031
Practice Address - Fax:702-656-7557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3331122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty