Provider Demographics
NPI:1588919724
Name:GABLER, HEATHER ANNE (DMD)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:ANNE
Last Name:GABLER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:ANNE
Other - Last Name:MORGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:926 GREAT POND DR STE 2003
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-7244
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3615 DUPONT AVE STE 200-400
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32217-2790
Practice Address - Country:US
Practice Address - Phone:888-954-5764
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-13
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 205831223P0221X, 1223P0221X
PADS0391721223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL012101200Medicaid
MD119591300Medicaid