Provider Demographics
NPI:1174606784
Name:GABEL, WILLIS P (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:WILLIS
Middle Name:P
Last Name:GABEL
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22500 SE 64TH PL
Mailing Address - Street 2:SUITE 110
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-8111
Mailing Address - Country:US
Mailing Address - Phone:425-427-1120
Mailing Address - Fax:425-427-1125
Practice Address - Street 1:22500 SE 64TH PL
Practice Address - Street 2:SUITE 110
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-8111
Practice Address - Country:US
Practice Address - Phone:425-427-1120
Practice Address - Fax:425-427-1125
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA63591223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics