Provider Demographics
NPI:1164732160
Name:ABDELBAKY & BOES II, PLLC
Entity Type:Organization
Organization Name:ABDELBAKY & BOES II, PLLC
Other - Org Name:TRIANGLE FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BOES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:919-469-2122
Mailing Address - Street 1:3415 ROGERS RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-3809
Mailing Address - Country:US
Mailing Address - Phone:919-554-9955
Mailing Address - Fax:919-554-9955
Practice Address - Street 1:3415 ROGERS RD
Practice Address - Street 2:SUITE 100
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-3809
Practice Address - Country:US
Practice Address - Phone:919-554-9955
Practice Address - Fax:919-554-9955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-09
Last Update Date:2010-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC84321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty