MEDICARE: DR. PAUL DAVID MABE D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	6651	KS
2	122300000X	Dentist	DN 15439	FL

General Provider Information

NPI Number	:	1891804860
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL DAVID MABE D.D.S.

Provider Business Mailing Address
First Line	:	877 111TH AVE N
Second Line	:	SUITE 3
City	:	NAPLES
State	:	FL
Zip	:	34108-1866
Country	:	US
Telephone Number	:	239-566-7737
Fax Number	:

Provider Business Practice Location Address
First Line	:	877 111TH AVE N
Second Line	:	SUITE 3
City	:	NAPLES
State	:	FL
Zip	:	34108-1866
Country	:	US
Telephone Number	:	239-566-7737
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	10/19/2015

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