Provider Demographics
NPI:1215605738
Name:FOERTSCH, ABIGAIL WARREN (DMD)
Entity Type:Individual
Prefix:DR
First Name:ABIGAIL
Middle Name:WARREN
Last Name:FOERTSCH
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3443 BEAVER DAM RD
Mailing Address - Street 2:
Mailing Address - City:STEWARTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17363-8142
Mailing Address - Country:US
Mailing Address - Phone:804-909-0513
Mailing Address - Fax:
Practice Address - Street 1:45 ROBINHOOD DR
Practice Address - Street 2:
Practice Address - City:ETTERS
Practice Address - State:PA
Practice Address - Zip Code:17319-9321
Practice Address - Country:US
Practice Address - Phone:717-938-4646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-31
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0437991223G0001X
MD176291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice