Provider Demographics
NPI:1114199114
Name:PAUL B GABRIEL DMD PC
Entity Type:Organization
Organization Name:PAUL B GABRIEL DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:BRYAN
Authorized Official - Last Name:GABRIEL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:724-935-2100
Mailing Address - Street 1:4001 STONEWOOD DRIVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090
Mailing Address - Country:US
Mailing Address - Phone:724-935-2100
Mailing Address - Fax:724-935-2133
Practice Address - Street 1:4001 STONEWOOD DRIVE
Practice Address - Street 2:SUITE 110
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090
Practice Address - Country:US
Practice Address - Phone:724-935-2100
Practice Address - Fax:724-935-2133
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PAUL B GABRIEL DMD PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-03-31
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS029315L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty