Provider Demographics
NPI:1235540766
Name:HENRY ABRAHAM DDS INC
Entity Type:Organization
Organization Name:HENRY ABRAHAM DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:
Authorized Official - Last Name:ABRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:951-204-7325
Mailing Address - Street 1:29049 OVERLAND DR STE C
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591-3637
Mailing Address - Country:US
Mailing Address - Phone:951-506-4900
Mailing Address - Fax:951-506-4955
Practice Address - Street 1:29049 OVERLAND DR STE C
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-3637
Practice Address - Country:US
Practice Address - Phone:951-506-4900
Practice Address - Fax:951-506-4955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-19
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty