Provider Demographics
NPI:1437398005
Name:ABERRDEEN FAMILY DENTAL PA
Entity Type:Organization
Organization Name:ABERRDEEN FAMILY DENTAL PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ABBATICCHIO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:908-237-1216
Mailing Address - Street 1:1077 RTE 34 STE J
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-2151
Mailing Address - Country:US
Mailing Address - Phone:732-441-3600
Mailing Address - Fax:732-441-3601
Practice Address - Street 1:1077 RTE 34 STE J
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:NJ
Practice Address - Zip Code:07747-2151
Practice Address - Country:US
Practice Address - Phone:732-441-3600
Practice Address - Fax:732-441-3601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-05
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI017432122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty