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General NPI Number Information
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NPI Number | 1275741035
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Entity Type | Individual
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Provider Name | MAE ABDALLA D.D.S
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Gender | Female
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3476 GLEN ERIN DR.
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City | MISSISSAUGA
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State | ONTARIO
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Zip | L5L3R4
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Country | CA
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Telephone | 905-820-4440
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Fax | 905-820-7712
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Provider Business Mailing Address
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Address Line | 1990 THE CHASE
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City | MISSISSAUGA
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State | ONTARIO
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Zip | L5M3A4
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Country | CA
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Telephone | 416-358-1415
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Fax | 905-569-7872
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 8880
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License Number State | CO
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