Provider Demographics
NPI:1285270603
Name:ABRI DENTAL OFFICE INC
Entity type:Organization
Organization Name:ABRI DENTAL OFFICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DR. DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:ABRI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:747-200-4234
Mailing Address - Street 1:3808 W RIVERSIDE DR STE 501
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-4396
Mailing Address - Country:US
Mailing Address - Phone:818-779-0299
Mailing Address - Fax:888-905-0578
Practice Address - Street 1:3808 W RIVERSIDE DR STE 501
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4396
Practice Address - Country:US
Practice Address - Phone:818-779-0299
Practice Address - Fax:888-905-0578
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-20
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB211572Medicaid