Organization
DR. RAFAEL GAMBOA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAFAEL M GAMBOA DDS (PRESIDENT)
(775) 322-8610
Entity
Organization
Contact information
Practice address
1601 LAKESIDE DR, RENO, NV 89509-3408
(775) 322-8610
(775) 322-7698
Mailing address
1601 LAKESIDE DR, RENO, NV 89509-3408
(775) 322-8610
(775) 322-7698
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
913
NV
Other
Enumeration date
09/20/2006
Last updated
08/22/2020
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