Individual
PATRICK J MCCABE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4646 NANTUCKET DR, STE A, TOLEDO, OH 43623-3194
(419) 843-2112
(419) 517-2104
Mailing address
4646 NANTUCKET DR, STE A, TOLEDO, OH 43623-3194
(419) 843-2121
(419) 517-2104
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
30-02-0621
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000127868
ANTHEM BC
OH
01
—
190009573
RR MEDICARE
OH
01
—
190009574
RR MEDICARE
OH
05
—
2149508
—
OH
Enumeration date
08/16/2005
Last updated
06/07/2011
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