Provider Demographics
NPI:1194948604
Name:ABBAS, ALI M (DMD)
Entity type:Individual
Prefix:DR
First Name:ALI
Middle Name:M
Last Name:ABBAS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:262 MORRIS AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07081-1214
Mailing Address - Country:US
Mailing Address - Phone:973-379-5177
Mailing Address - Fax:973-379-2534
Practice Address - Street 1:262 MORRIS AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07081-1214
Practice Address - Country:US
Practice Address - Phone:973-379-5177
Practice Address - Fax:973-379-2534
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI208201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice