Provider Demographics
NPI:1821330846
Name:GABIN, PAUL S (DMD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:S
Last Name:GABIN
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 1:761 HUMBOLDT ST
Mailing Address - Street 2:
Mailing Address - City:SECAUCUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07094-3232
Mailing Address - Country:US
Mailing Address - Phone:201-865-1150
Mailing Address - Fax:201-865-1236
Practice Address - Street 1:761 HUMBOLDT ST
Practice Address - Street 2:
Practice Address - City:SECAUCUS
Practice Address - State:NJ
Practice Address - Zip Code:07094-3232
Practice Address - Country:US
Practice Address - Phone:201-865-1150
Practice Address - Fax:201-865-1236
Is Sole Proprietor?:No
Enumeration Date:2013-03-18
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ103571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJD01808100OtherSTATE CDS