Individual
MR. TIM MABE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1218 N MAIN STREET, WALNUTE COVE, NC 27052
(336) 591-4303
(336) 591-4516
Mailing address
PO BOX 648, WALNUT COVE, NC 27052
(336) 591-8118
(336) 591-4516
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
104574
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8902103
—
NC
01
—
8995436
UNITED HEALTHCARE
—
Enumeration date
08/28/2006
Last updated
07/08/2007
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