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General NPI Number Information
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NPI Number | 1942675848
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Entity Type | Organization
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Legal Business Name | ABBAS DENTAL CORPORATION
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Dates
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Enumeration Date | 12/04/2015
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Last Update Date | 05/03/2019
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Provider Practice Location Address
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Address Line | 3880 TRUXEL RD STE 600
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City | SACRAMENTO
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State | CA
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Zip | 95834-3615
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Country | US
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Telephone | 916-384-5579
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Fax |
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Provider Business Mailing Address
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Address Line | 3880 TRUXEL RD STE 500
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City | SACRAMENTO
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State | CA
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Zip | 95834-3615
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Country | US
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Telephone | 916-384-5579
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HAYTHAM M.ADEL ABBAS
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Credential | DDS
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Telephone | 916-384-5579
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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 | 53744
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License Number State | CA
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