Provider Demographics
NPI:1265788210
Name:GUBLER, MITCHELL MILES (DDS)
Entity type:Individual
Prefix:DR
First Name:MITCHELL
Middle Name:MILES
Last Name:GUBLER
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 1:794 SWISS HAVEN CIR
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:UT
Mailing Address - Zip Code:84765-5651
Mailing Address - Country:US
Mailing Address - Phone:435-669-6157
Mailing Address - Fax:
Practice Address - Street 1:368 E RIVERSIDE DR STE 7
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-7278
Practice Address - Country:US
Practice Address - Phone:435-688-1344
Practice Address - Fax:435-688-1845
Is Sole Proprietor?:No
Enumeration Date:2012-07-27
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9423392-99231223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics