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General NPI Number Information
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NPI Number | 1003823436
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Entity Type | Individual
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Provider Name | CHRISTOPHER PATRICK MCABOY DDS
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Gender | Male
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 09/25/2020
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Provider Practice Location Address
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Address Line | 377 W RIVER WOODS PARKWAY SUITE #120
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City | GLENDALE
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State | WI
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Zip | 53212
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Country | US
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Telephone | 414-906-8940
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Fax | 414-906-8950
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Provider Business Mailing Address
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Address Line | 377 W RIVER WOODS PARKWAY SUITE #120
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City | GLENDALE
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State | WI
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Zip | 53212
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Country | US
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Telephone | 414-906-8940
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Fax | 414-906-8950
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 5603-015
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 5401
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License Number State | WI
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