Provider Demographics
NPI:1366875791
Name:OBERMAYR, GAYLE (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:GAYLE
Middle Name:
Last Name:OBERMAYR
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4660 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33870-2063
Mailing Address - Country:US
Mailing Address - Phone:863-382-9947
Mailing Address - Fax:863-382-8021
Practice Address - Street 1:4660 LAKEVIEW DR
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-2063
Practice Address - Country:US
Practice Address - Phone:863-382-9947
Practice Address - Fax:863-382-8021
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-21
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN113291223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics