Provider Demographics
NPI:1124159348
Name:GILBERT, DARREL J (DDS)
Entity type:Individual
Prefix:DR
First Name:DARREL
Middle Name:J
Last Name:GILBERT
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 1:6667 VERNON WOODS DR NE
Mailing Address - Street 2:SUITE B-30
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30328-3215
Mailing Address - Country:US
Mailing Address - Phone:404-255-7047
Mailing Address - Fax:404-843-1273
Practice Address - Street 1:6667 VERNON WOODS DR NE
Practice Address - Street 2:SUITE B-30
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328-3215
Practice Address - Country:US
Practice Address - Phone:404-255-7047
Practice Address - Fax:404-843-1273
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA9425122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist