MEDICARE: DAVID JOHN CABAN OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	2642	MA
2	152W00000X	Optometrist	335	NH
3	152W00000X	Optometrist	0335	NH

General Provider Information

NPI Number	:	1184617235
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID JOHN CABAN OD

Provider Business Mailing Address
First Line	:	145 HOLLIS ST
Second Line	:
City	:	MANCHESTER
State	:	NH
Zip	:	03101-1235
Country	:	US
Telephone Number	:	603-626-9500
Fax Number	:	603-626-9523

Provider Business Practice Location Address
First Line	:	184 TARRYTOWN RD
Second Line	:
City	:	MANCHESTER
State	:	NH
Zip	:	03103-2713
Country	:	US
Telephone Number	:	36-269-5006
Fax Number	:	603-626-9523

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2005
Last Update Date	:	08/03/2021

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Directions to “ DAVID JOHN CABAN OD” Practice Location

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