Individual
CARLY GUBIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
904 W UNIVERSITY AVE STE 101, GEORGETOWN, TX 78626-6512
(615) 329-4790
Mailing address
1804 W 6TH ST UNIT B, AUSTIN, TX 78703-4704
(901) 233-9003
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
11919
TN
1223G0001X
General Practice Dentistry
Primary
40045
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/28/2022
Last updated
09/27/2023
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