Provider Demographics
NPI:1174816425
Name:ABELDT, SUSAN MARGARET (DDS)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:MARGARET
Last Name:ABELDT
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 1:102 FRENCH GULCH CT
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-7104
Mailing Address - Country:US
Mailing Address - Phone:916-792-1431
Mailing Address - Fax:
Practice Address - Street 1:1113 HIGHWAY 49
Practice Address - Street 2:STE A
Practice Address - City:SAN ANDREAS
Practice Address - State:CA
Practice Address - Zip Code:95249-9583
Practice Address - Country:US
Practice Address - Phone:209-755-1460
Practice Address - Fax:209-754-6278
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-19
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA338891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice