Provider Demographics
NPI:1962693614
Name:ANDERSON, GABRIELA (DDS)
Entity type:Individual
Prefix:
First Name:GABRIELA
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8790 HILLCREST RD
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90621-1014
Mailing Address - Country:US
Mailing Address - Phone:714-739-1391
Mailing Address - Fax:
Practice Address - Street 1:8790 HILLCREST RD
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90621-1014
Practice Address - Country:US
Practice Address - Phone:714-739-1391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-07
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46016122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist