Provider Demographics
NPI:1366013690
Name:HOLLISTON COMPLETE DENTISTRY, PC
Entity Type:Organization
Organization Name:HOLLISTON COMPLETE DENTISTRY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SABAHAT
Authorized Official - Middle Name:
Authorized Official - Last Name:ABERNETHY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:617-694-5902
Mailing Address - Street 1:3 FORSYTHIA DR
Mailing Address - Street 2:
Mailing Address - City:WALPOLE
Mailing Address - State:MA
Mailing Address - Zip Code:02081-3647
Mailing Address - Country:US
Mailing Address - Phone:617-694-5902
Mailing Address - Fax:
Practice Address - Street 1:1660 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:HOLLISTON
Practice Address - State:MA
Practice Address - Zip Code:01746-1789
Practice Address - Country:US
Practice Address - Phone:508-429-5300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-07
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty