Provider Demographics
NPI:1215064548
Name:CAPDEVILA, GABRIEL E (DDS)
Entity type:Individual
Prefix:DR
First Name:GABRIEL
Middle Name:E
Last Name:CAPDEVILA
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 1:6082 EDINGER AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647
Mailing Address - Country:US
Mailing Address - Phone:714-846-2895
Mailing Address - Fax:714-846-2895
Practice Address - Street 1:6082 EDINGER AVE
Practice Address - Street 2:SUITE A
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647
Practice Address - Country:US
Practice Address - Phone:714-846-2895
Practice Address - Fax:714-846-2895
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA413641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice