Provider Demographics
NPI:1306236583
Name:THE CARABELLI GROUP, LLC
Entity type:Organization
Organization Name:THE CARABELLI GROUP, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:
Authorized Official - Last Name:PATTEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-288-7379
Mailing Address - Street 1:5039 HIGHWAY 52 N
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-0166
Mailing Address - Country:US
Mailing Address - Phone:507-282-7905
Mailing Address - Fax:507-286-9832
Practice Address - Street 1:5039 HIGHWAY 52 N
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-0166
Practice Address - Country:US
Practice Address - Phone:507-282-7905
Practice Address - Fax:507-286-9832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-27
Last Update Date:2015-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND129931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty