Provider Demographics
NPI:1144117086
Name:PABLO, MARIA CORINA (DDS)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:CORINA
Last Name:PABLO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1733 CHARLESWOOD ESTATES DR
Mailing Address - Street 2:
Mailing Address - City:WEST FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58078-4201
Mailing Address - Country:US
Mailing Address - Phone:504-256-1536
Mailing Address - Fax:
Practice Address - Street 1:3207 11TH ST S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-6238
Practice Address - Country:US
Practice Address - Phone:701-235-7322
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-23
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND25641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice