Provider Demographics
NPI:1659069375
Name:PEREZ, GABRIEL (DMD)
Entity type:Individual
Prefix:DR
First Name:GABRIEL
Middle Name:
Last Name:PEREZ
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 BUENA VISTA AVE
Mailing Address - Street 2:
Mailing Address - City:LANDISVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08326-1435
Mailing Address - Country:US
Mailing Address - Phone:856-558-2848
Mailing Address - Fax:
Practice Address - Street 1:776 GROVE RD
Practice Address - Street 2:
Practice Address - City:WEST DEPTFORD
Practice Address - State:NJ
Practice Address - Zip Code:08086-2234
Practice Address - Country:US
Practice Address - Phone:856-848-2211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-01
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI030856001223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry