Provider Demographics
NPI:1568671295
Name:ABOAFCH, MAAEN (DMD)
Entity Type:Individual
Prefix:
First Name:MAAEN
Middle Name:
Last Name:ABOAFCH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:385 STARR RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LANDENBERG
Mailing Address - State:PA
Mailing Address - Zip Code:19350-9222
Mailing Address - Country:US
Mailing Address - Phone:610-268-2040
Mailing Address - Fax:610-268-2061
Practice Address - Street 1:385 STARR RD
Practice Address - Street 2:SUITE 202
Practice Address - City:LANDENBERG
Practice Address - State:PA
Practice Address - Zip Code:19350-9222
Practice Address - Country:US
Practice Address - Phone:610-268-2040
Practice Address - Fax:610-268-2061
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0371571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice