Provider Demographics
NPI:1982733093
Name:CANO, GABRIEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:GABRIEL
Middle Name:
Last Name:CANO
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 1:1237 ALTISSIMO PL
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95131-3595
Mailing Address - Country:US
Mailing Address - Phone:408-739-9047
Mailing Address - Fax:408-739-9092
Practice Address - Street 1:1565 HOLLENBECK AVE STE 112
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-4300
Practice Address - Country:US
Practice Address - Phone:408-739-9047
Practice Address - Fax:408-739-9092
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA456571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice