Provider Demographics
NPI:1417959974
Name:BHAIJI, ABID F (DDS, MS)
Entity Type:Individual
Prefix:
First Name:ABID
Middle Name:F
Last Name:BHAIJI
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 516
Mailing Address - Street 2:
Mailing Address - City:WRIGHT CITY
Mailing Address - State:MO
Mailing Address - Zip Code:63390-0516
Mailing Address - Country:US
Mailing Address - Phone:636-745-2424
Mailing Address - Fax:636-745-2424
Practice Address - Street 1:109 WESTWOODS RD
Practice Address - Street 2:
Practice Address - City:WRIGHT CITY
Practice Address - State:MO
Practice Address - Zip Code:63390-3306
Practice Address - Country:US
Practice Address - Phone:636-745-2424
Practice Address - Fax:636-745-2424
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO014936122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist