Provider Demographics
NPI:1619181047
Name:GABRIEL, BRENT FRANKLIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRENT
Middle Name:FRANKLIN
Last Name:GABRIEL
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 1:230 N PARK BLVD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-6981
Mailing Address - Country:US
Mailing Address - Phone:817-424-2993
Mailing Address - Fax:
Practice Address - Street 1:230 N PARK BLVD
Practice Address - Street 2:SUITE 108
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-6981
Practice Address - Country:US
Practice Address - Phone:817-424-2993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX171911223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics