Provider Demographics
NPI:1629018650
Name:GEHL, ABBY LEE (DDS)
Entity Type:Individual
Prefix:DR
First Name:ABBY
Middle Name:LEE
Last Name:GEHL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:ABBY
Other - Middle Name:LEE
Other - Last Name:PAPE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:119 SOUTH MAIN STE 1
Mailing Address - Street 2:
Mailing Address - City:MAQUOKETA
Mailing Address - State:IA
Mailing Address - Zip Code:52060
Mailing Address - Country:US
Mailing Address - Phone:563-652-4133
Mailing Address - Fax:563-652-0443
Practice Address - Street 1:119 SOUTH MAIN STE 1
Practice Address - Street 2:
Practice Address - City:MAQUOKETA
Practice Address - State:IA
Practice Address - Zip Code:52060
Practice Address - Country:US
Practice Address - Phone:563-652-4133
Practice Address - Fax:563-652-0443
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA8368122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
8368OtherIA LIC
8368OtherDELTA
IA0464354Medicare ID - Type Unspecified