Individual
LUIS FERNANDO GAMBOA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3110 NEW BERN AVE STE 102, RALEIGH, NC 27610-1200
(984) 242-0568
Mailing address
3110 NEW BERN AVE STE 102, RALEIGH, NC 27610-1200
(984) 242-0568
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11701
NC
Other
Enumeration date
06/25/2019
Last updated
12/03/2024
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