Provider Demographics
NPI:1346347424
Name:FRABIZZIO, DEEPA PATEL (DMD)
Entity Type:Individual
Prefix:
First Name:DEEPA
Middle Name:PATEL
Last Name:FRABIZZIO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:DEEPA
Other - Middle Name:
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:24 BRECKNOCK COURT
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-2411
Mailing Address - Country:US
Mailing Address - Phone:215-579-0599
Mailing Address - Fax:
Practice Address - Street 1:410 EXECUTIVE DR
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047
Practice Address - Country:US
Practice Address - Phone:215-968-0142
Practice Address - Fax:215-968-4735
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS035686122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist