Provider Demographics
NPI:1215928445
Name:GASPARD, EUGENE MICHAEL (DDS)
Entity type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:MICHAEL
Last Name:GASPARD
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 1:4806 LAKE FOREST DR
Mailing Address - Street 2:
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68133-4750
Mailing Address - Country:US
Mailing Address - Phone:402-292-3557
Mailing Address - Fax:
Practice Address - Street 1:11513 S 37TH ST
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68123-5210
Practice Address - Country:US
Practice Address - Phone:402-292-1200
Practice Address - Fax:402-292-5657
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE59381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice