Provider Demographics
NPI:1720490618
Name:DANIEL T GILBERT, DDS, PA
Entity Type:Organization
Organization Name:DANIEL T GILBERT, DDS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:GILBERT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:785-628-6469
Mailing Address - Street 1:2702 VINE ST
Mailing Address - Street 2:SUITE #3
Mailing Address - City:HAYS
Mailing Address - State:KS
Mailing Address - Zip Code:67601-1926
Mailing Address - Country:US
Mailing Address - Phone:785-628-6469
Mailing Address - Fax:785-628-2150
Practice Address - Street 1:2702 VINE ST
Practice Address - Street 2:SUITE #3
Practice Address - City:HAYS
Practice Address - State:KS
Practice Address - Zip Code:67601-1926
Practice Address - Country:US
Practice Address - Phone:785-628-6469
Practice Address - Fax:785-628-2150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-27
Last Update Date:2014-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS60951122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty