Provider Demographics
NPI:1407984214
Name:FABRE, DAVID DOUGLAS (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:DOUGLAS
Last Name:FABRE
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 1:2111 59TH ST W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-7015
Mailing Address - Country:US
Mailing Address - Phone:941-792-4166
Mailing Address - Fax:
Practice Address - Street 1:2111 59TH ST W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-7015
Practice Address - Country:US
Practice Address - Phone:941-792-4166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN138901223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics