Provider Demographics
NPI:1962847285
Name:GABBARD, ANGELA DAVIDSON (DMD)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:DAVIDSON
Last Name:GABBARD
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 HARDIN LN STE A
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503-3812
Mailing Address - Country:US
Mailing Address - Phone:606-425-5504
Mailing Address - Fax:606-425-5804
Practice Address - Street 1:100 HARDIN LN STE A
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-3812
Practice Address - Country:US
Practice Address - Phone:606-425-5504
Practice Address - Fax:606-425-5804
Is Sole Proprietor?:No
Enumeration Date:2013-04-30
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY93331223P0221X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry