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General NPI Number Information
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NPI Number | 1568658482
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Entity Type | Individual
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Provider Name | DEXTER DANCEL CABRAL
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Gender | Male
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Dates
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Enumeration Date | 09/25/2007
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | PSC 490 BOX 7607
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City | FPO
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State | AP
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Zip | 96538
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Country | US
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Telephone | 671-339-7118
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Fax |
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Provider Business Mailing Address
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Address Line | 310 LADERA LANE SUITE 908
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City | MANGILAO
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State | GU
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Zip | 96913
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Country | US
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Telephone | 671-339-7118
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Fax |
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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 | 1710I1002X
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Taxonomy Name | Independent Duty Corpsman
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License Number |
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License Number State |
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