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General NPI Number Information
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NPI Number | 1801200761
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Entity Type | Organization
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Legal Business Name | TAMARA K. ABBETT, DDS, PC
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Dates
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Enumeration Date | 06/18/2014
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Last Update Date | 06/18/2014
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Provider Practice Location Address
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Address Line | 940 ELLENDALE DR
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City | MEDFORD
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State | OR
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Zip | 97504-8216
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Country | US
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Telephone | 541-779-9059
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Fax | 541-779-0226
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Provider Business Mailing Address
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Address Line | 940 ELLENDALE DR
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City | MEDFORD
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State | OR
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Zip | 97504-8216
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Country | US
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Telephone | 541-779-9059
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Fax | 541-779-0226
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | TAMARA KAY ABBETT
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Credential | DDS
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Telephone | 541-779-9059
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | D6842
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License Number State | OR
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