Provider Demographics
NPI:1477518942
Name:CABELL, MARJORIE MAE (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARJORIE
Middle Name:MAE
Last Name:CABELL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 E DIAMOND AVE
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47711-3714
Mailing Address - Country:US
Mailing Address - Phone:812-461-2365
Mailing Address - Fax:812-461-2366
Practice Address - Street 1:400 E DIAMOND AVE
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47711-3714
Practice Address - Country:US
Practice Address - Phone:812-461-2365
Practice Address - Fax:812-461-2366
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS029852L122300000X
GADN0134921223G0001X, 122300000X
IN12013316A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist