Provider Demographics
NPI:1265603211
Name:WILLIAM C RABE DMD PA
Entity type:Organization
Organization Name:WILLIAM C RABE DMD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:CLARK
Authorized Official - Last Name:RABE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:336-626-9989
Mailing Address - Street 1:350 NORTH COX STREET
Mailing Address - Street 2:SUITE #3
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27203-5514
Mailing Address - Country:US
Mailing Address - Phone:336-626-9989
Mailing Address - Fax:336-626-0701
Practice Address - Street 1:350 NORTH COX STREET
Practice Address - Street 2:SUITE #3
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-5514
Practice Address - Country:US
Practice Address - Phone:336-626-9989
Practice Address - Fax:336-626-0701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-18
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC41501223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8997217Medicaid
NC8997217Medicaid