Provider Demographics
NPI:1023208857
Name:MCDONALD, CABEL ARON (DDS)
Entity Type:Individual
Prefix:DR
First Name:CABEL
Middle Name:ARON
Last Name:MCDONALD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:855 11TH AVE STE B
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632-2461
Mailing Address - Country:US
Mailing Address - Phone:360-425-7220
Mailing Address - Fax:360-425-5045
Practice Address - Street 1:855 11TH AVE STE B
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632
Practice Address - Country:US
Practice Address - Phone:360-425-7220
Practice Address - Fax:360-425-5045
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-27
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000109561223G0001X
VA04380003181223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No1223G0001XDental ProvidersDentistGeneral Practice