Provider Demographics
NPI:1346335411
Name:GABRIEL, PAUL B (DMD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:B
Last Name:GABRIEL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 BROOKTREE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-9278
Mailing Address - Country:US
Mailing Address - Phone:724-935-2100
Mailing Address - Fax:724-935-2133
Practice Address - Street 1:2500 BROOKTREE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-9278
Practice Address - Country:US
Practice Address - Phone:724-935-2100
Practice Address - Fax:724-935-2133
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS 029315L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA790410OtherUNITED CONCORDIA PROVIDER