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General NPI Number Information
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NPI Number | 1861645202
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Entity Type | Individual
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Provider Name | MICHAEL VERLYN DABELL DMD
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Gender | Male
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Dates
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Enumeration Date | 10/29/2008
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Last Update Date | 06/14/2013
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Provider Practice Location Address
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Address Line | 1550 N CRESTMONT DR STE G
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City | MERIDIAN
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State | ID
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Zip | 83642-2177
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Country | US
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Telephone | 208-884-0100
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Fax | 208-884-4844
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Provider Business Mailing Address
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Address Line | 1550 N CRESTMONT DR STE G
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City | MERIDIAN
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State | ID
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Zip | 83642-2177
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Country | US
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Telephone | 208-884-0100
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Fax | 208-884-4844
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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 | DR 60035396
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | D-4099-OS
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License Number State | ID
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