Provider Demographics
NPI:1306933916
Name:GABREK, DANIEL F (DDS, MSD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:F
Last Name:GABREK
Suffix:
Gender:M
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7750 W JEFFERSON BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46804-4174
Mailing Address - Country:US
Mailing Address - Phone:260-432-0577
Mailing Address - Fax:230-432-0578
Practice Address - Street 1:7750 W JEFFERSON BLVD
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46804-4174
Practice Address - Country:US
Practice Address - Phone:260-432-0577
Practice Address - Fax:230-432-0578
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN9117A1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics