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General NPI Number Information
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NPI Number | 1497196117
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Entity Type | Individual
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Provider Name | PETER ABUDE D.D.S
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Gender | Male
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Dates
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Enumeration Date | 07/10/2013
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Last Update Date | 12/22/2020
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Provider Practice Location Address
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Address Line | 28895 GREENSPOT RD UNIT 103
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City | HIGHLAND
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State | CA
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Zip | 92346-5770
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Country | US
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Telephone | 909-280-5342
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Fax | 909-566-0138
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Provider Business Mailing Address
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Address Line | 28895 GREENSPOT RD UNIT 103
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City | HIGHLAND
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State | CA
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Zip | 92346-5770
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Country | US
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Telephone | 909-280-5342
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Fax | 909-566-0138
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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 | 62541
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License Number State | CA
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