Provider Demographics
NPI:1518089903
Name:ABERNETHY, SABAHAT KHAN (DMD, CAGS)
Entity Type:Individual
Prefix:DR
First Name:SABAHAT
Middle Name:KHAN
Last Name:ABERNETHY
Suffix:
Gender:F
Credentials:DMD, CAGS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87 JASPER LN
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-4093
Mailing Address - Country:US
Mailing Address - Phone:617-694-5902
Mailing Address - Fax:
Practice Address - Street 1:469 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:ABINGTON
Practice Address - State:MA
Practice Address - Zip Code:02351-2417
Practice Address - Country:US
Practice Address - Phone:781-878-2190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA217181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice