Healthcare Provider Details

I. General information

NPI: 1578789319
Provider Name (Legal Business Name): JOSEPH G ABOOD, JR, DDS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7425 W HAMPDEN AVE
LAKEWOOD CO
80227-5171
US

IV. Provider business mailing address

14416 W 57TH PL
ARVADA CO
80002-1167
US

V. Phone/Fax

Practice location:
  • Phone: 303-988-7410
  • Fax: 30-988-3800
Mailing address:
  • Phone: 303-432-2384
  • Fax: 303-954-0099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QS0112X
TaxonomyOral and Maxillofacial Surgery Clinic/Center
License Number8896
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code261QS0112X
TaxonomyOral and Maxillofacial Surgery Clinic/Center
License Number8896
License Number StateCO

VIII. Authorized Official

Name: DR. JOSEPH GEORGLOE ABOOD
Title or Position: ORAL & MAXILLOFACIAL SURGEON
Credential: DDS
Phone: 303-988-7140