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General NPI Number Information
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NPI Number | 1790642791
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Entity Type | Organization
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Legal Business Name | ABM ORTHODONTICS PA
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Dates
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Enumeration Date | 01/09/2026
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Last Update Date | 01/09/2026
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Provider Practice Location Address
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Address Line | 1180 PONCE DE LEON BLVD STE 501
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City | CLEARWATER
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State | FL
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Zip | 33756-1031
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Country | US
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Telephone | 727-605-2266
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Fax |
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Provider Business Mailing Address
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Address Line | 1180 PONCE DE LEON BLVD STE 501
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City | CLEARWATER
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State | FL
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Zip | 33756-1031
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Country | US
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Telephone | 727-605-2266
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Fax |
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Authorized Official
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Title or Position | MBR
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Name | ASHKAN MAHDAVI
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Credential | DMD
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Telephone | 818-274-4424
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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