Individual
DR. ROBERT TODD MABRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4636 W JEFFERSON BLVD, FORT WAYNE, IN 46804-6826
(260) 436-9439
(260) 436-9467
Mailing address
4636 W JEFFERSON BLVD, FORT WAYNE, IN 46804-6826
(260) 436-9439
(260) 436-9467
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
19654
OH
1223E0200X
Endodontics
Primary
8592
IN
Other
Enumeration date
11/01/2006
Last updated
07/08/2007
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