James Edgar Mabon Jr., D.D.S.
Individual provider Active NPI General Practice Dentistry · Muncy, PA
NPI 1306862974 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1306862974
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- DS020314L (PA)
- Practice address
- 2410 State Route 405
Muncy, PA 17756-6709 - Phone
- (570) 546-6817
- Fax
- (570) 546-8353
- NPI assigned
- Jul 15, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS020314L | PA | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DS020314L | PA | Yes |
Addresses
Primary practice location
2410 State Route 405
Muncy, PA 17756-6709
Mailing address
2410 State Route 405
Muncy, PA 17756-6709
Phone (570) 546-6817
Other providers in Muncy, PA
- Kristopher Shawn Laubach
- Paul Edward Leber
- Jamie E Leighow
- Joseph J Lexon
- Luxottica of America Inc
- Erika Elizabeth Mabus Carper
- Bindhu Madathil
- Jason Shing-Yau Mah
- George Alden Manchester
- Manuel V Moreno
All providers in Muncy, PA · General Practice Dentistry in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.