Provider Demographics
NPI:1609657055
Name:MARCO ABDULLAH DDS & ASSOCIATES INC
Entity Type:Organization
Organization Name:MARCO ABDULLAH DDS & ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCO
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDULLAH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:510-600-2415
Mailing Address - Street 1:1016 E COOLEY DR STE F
Mailing Address - Street 2:
Mailing Address - City:COLTON
Mailing Address - State:CA
Mailing Address - Zip Code:92324-3961
Mailing Address - Country:US
Mailing Address - Phone:909-283-1328
Mailing Address - Fax:909-639-1143
Practice Address - Street 1:1016 E COOLEY DR STE F
Practice Address - Street 2:
Practice Address - City:COLTON
Practice Address - State:CA
Practice Address - Zip Code:92324-3961
Practice Address - Country:US
Practice Address - Phone:909-283-1328
Practice Address - Fax:909-639-1143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-11
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental