| Dr. Rafael Gamboa | |
|
1601 Lakeside Dr Reno NV 89509-3408 | |
| (775) 322-8610 | |
| (775) 322-7698 |
| Full Name | Dr. Rafael Gamboa |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 1601 Lakeside Dr, Reno, Nevada |
| Authorized Official Name and Position | Rafael M Gamboa (PRESIDENT) |
| Authorized Official Contact | 7753228610 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Rafael Gamboa 1601 Lakeside Dr Reno NV 89509-3408 Ph: (775) 322-8610 | Dr. Rafael Gamboa 1601 Lakeside Dr Reno NV 89509-3408 Ph: (775) 322-8610 |
| NPI Number | 1649378324 |
|---|---|
| Provider Enumeration Date | 09/20/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649378324 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | 913 (Nevada) | Primary |
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