Provider Demographics
NPI:1679689053
Name:CAUBLE, DAVID A (DMD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:A
Last Name:CAUBLE
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 1:910 SW SIMPSON AVE
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-3117
Mailing Address - Country:US
Mailing Address - Phone:541-382-8575
Mailing Address - Fax:541-382-8681
Practice Address - Street 1:910 SW SIMPSON AVE
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-3117
Practice Address - Country:US
Practice Address - Phone:541-382-8575
Practice Address - Fax:541-382-8681
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD79121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice