Provider Demographics
NPI:1497196117
Name:ABUDE, PETER (DDS)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:
Last Name:ABUDE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:PETER
Other - Middle Name:OBIAJURU
Other - Last Name:ABUDE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:28895 GREENSPOT RD UNIT 103
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:CA
Mailing Address - Zip Code:92346-5770
Mailing Address - Country:US
Mailing Address - Phone:909-280-5342
Mailing Address - Fax:909-566-0138
Practice Address - Street 1:28895 GREENSPOT RD UNIT 103
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:CA
Practice Address - Zip Code:92346-5770
Practice Address - Country:US
Practice Address - Phone:909-280-5342
Practice Address - Fax:909-566-0138
Is Sole Proprietor?:No
Enumeration Date:2013-07-10
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA625411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice