Provider Demographics
NPI:1659558815
Name:GABRIEL INC.
Entity Type:Organization
Organization Name:GABRIEL INC.
Other - Org Name:D.B.A FOREST HILLS DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FRITZ
Authorized Official - Middle Name:F
Authorized Official - Last Name:GABRIEL
Authorized Official - Suffix:
Authorized Official - Credentials:AADOM
Authorized Official - Phone:617-901-5722
Mailing Address - Street 1:1815 DORCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER CENTER
Mailing Address - State:MA
Mailing Address - Zip Code:02124-2551
Mailing Address - Country:US
Mailing Address - Phone:617-522-7414
Mailing Address - Fax:617-522-1425
Practice Address - Street 1:1815 DORCHESTER AVE
Practice Address - Street 2:
Practice Address - City:DORCHESTER CENTER
Practice Address - State:MA
Practice Address - Zip Code:02124-2551
Practice Address - Country:US
Practice Address - Phone:617-522-7414
Practice Address - Fax:617-522-1425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-29
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA214641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty