Individual
JONATHAN COLIN MCCABE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, DMD
Contact information
Practice address
116 CHAUCER CT, MANKATO, MN 56001-5600
(507) 327-9574
Mailing address
116 CHAUCER CT, MANKATO, MN 56001-5600
(507) 327-9574
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DN20400
FL
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/30/2011
Last updated
07/21/2022
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