Gambill, Micahel Jason

Gambill, Micahel Jason is an sole proprietor health care provider with primary practice located at 2285 Benton Rd Ste C100 , Bossier City LA 71111-3465. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Gambill, Micahel Jason can be contacted via phone (318) 742-9333.

Contact Information

Primary practice address
2285 Benton Rd Ste C100 Bossier City LA 71111-3465
Phone: (318) 742-9333
Fax: (318) 747-9089
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X 00201959 Colorado
Dental Providers / Pediatric Dentistry 1223P0221X 6422 Louisiana

Profile Details

NPI number 1023454071
LBN Legal business name Gambill, Micahel Jason
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 17th, 2013
Last updated Nov 16th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023454071 NPPES
Louisiana MEDICAID 30872

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