Provider Demographics
NPI:1174147292
Name:GILBERT-ORREGO, CAROL (DMD)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:GILBERT-ORREGO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1844 NW 42ND AVE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-1935
Mailing Address - Country:US
Mailing Address - Phone:407-556-4702
Mailing Address - Fax:
Practice Address - Street 1:1844 NW 42ND AVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-1935
Practice Address - Country:US
Practice Address - Phone:407-556-4702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-04
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL24942122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist