Provider Demographics
NPI:1093919193
Name:GABALL, EARL E (DDS)
Entity Type:Individual
Prefix:DR
First Name:EARL
Middle Name:E
Last Name:GABALL
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 1:250 NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49017-3428
Mailing Address - Country:US
Mailing Address - Phone:269-883-1674
Mailing Address - Fax:269-962-1694
Practice Address - Street 1:250 NORTH AVE
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49017-3428
Practice Address - Country:US
Practice Address - Phone:269-883-1674
Practice Address - Fax:269-962-1694
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI096081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice