Provider Demographics
NPI:1790667038
Name:YODER, ABIGAIL RENEE (DDS)
Entity type:Individual
Prefix:DR
First Name:ABIGAIL
Middle Name:RENEE
Last Name:YODER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51243 LEEWARD PT
Mailing Address - Street 2:
Mailing Address - City:GRANGER
Mailing Address - State:IN
Mailing Address - Zip Code:46530-4826
Mailing Address - Country:US
Mailing Address - Phone:574-286-7390
Mailing Address - Fax:
Practice Address - Street 1:1099 N MAIN ST STE 102
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29483-7300
Practice Address - Country:US
Practice Address - Phone:843-536-8577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-25
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC111951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice