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General NPI Number Information
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NPI Number | 1679881031
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Entity Type | Individual
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Provider Name | TYLER DABEL D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 09/20/2010
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Last Update Date | 12/03/2012
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Provider Practice Location Address
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Address Line | 4048 LINCOLN AVE
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City | GROVES
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State | TX
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Zip | 77619-4640
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Country | US
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Telephone | 409-962-2273
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Fax | 409-962-0129
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Provider Business Mailing Address
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Address Line | 4048 LINCOLN AVE
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City | GROVES
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State | TX
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Zip | 77619-4640
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Country | US
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Telephone | 409-962-2273
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Fax | 409-962-0129
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 25542
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License Number State | TX
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