Organization
DRS MABE & MABE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIM MABE DDS (PRESIDENT)
(336) 591-4303
Entity
Organization
Contact information
Practice address
1218 N MAIN STREET, WALNUT COVE, NC 27052
(336) 591-4303
(336) 591-4516
Mailing address
PO BOX 648, WALNUT COVE, NC 27052
(336) 591-4303
(336) 591-4516
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
104509
NC
122300000X
Dentist
104574
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8902103
—
NC
Enumeration date
08/09/2006
Last updated
08/22/2020
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