Healthcare Provider Details

I. General information

NPI: 1851651368
Provider Name (Legal Business Name): LOUIS M ABBEY DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2012
Last Update Date: 05/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 1ST ST 4TH FLOOR
CAMBRIDGE MA
02141-1802
US

IV. Provider business mailing address

1 CRANBERRY HL SUITE 303
LEXINGTON MA
02421-7394
US

V. Phone/Fax

Practice location:
  • Phone: 800-325-7284
  • Fax: 617-252-6563
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0106X
TaxonomyOral and Maxillofacial Pathology Dentistry
License NumberDN10556
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: