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NPI 1932390101

NPI 1932390101 : SUSAN CABADAS D.D.S. : ALLEN PARK, MI

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General NPI Number Information
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    NPI Number           |    1932390101
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    Entity Type          |    Individual 
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    Provider Name        |    SUSAN CABADAS D.D.S.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/05/2007
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    Last Update Date     |    08/05/2007
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Provider Practice Location Address
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    Address Line         |    8048 ALLEN RD 
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    City                 |    ALLEN PARK
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    State                |    MI
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    Zip                  |    48101-1706
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    Country              |    US
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    Telephone            |    313-382-8893
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    Fax                  |    313-928-3209
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Provider Business Mailing Address
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    Address Line         |    8048 ALLEN RD 
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    City                 |    ALLEN PARK
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    State                |    MI
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    Zip                  |    48101-1706
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    Country              |    US
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    Telephone            |    313-382-8893
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    Fax                  |    313-928-3209
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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       |    2901017491
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    License Number State |    MI
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