Provider Demographics
NPI:1679860407
Name:ABREU, EDWARD R (DMD)
Entity Type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:R
Last Name:ABREU
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:EDWARD
Other - Middle Name:R
Other - Last Name:ABREU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:117 N OAKWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33510-4629
Mailing Address - Country:US
Mailing Address - Phone:813-530-0991
Mailing Address - Fax:813-530-0986
Practice Address - Street 1:117 N OAKWOOD AVE
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33510-4629
Practice Address - Country:US
Practice Address - Phone:813-530-0991
Practice Address - Fax:813-530-0986
Is Sole Proprietor?:No
Enumeration Date:2011-06-30
Last Update Date:2016-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 194261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice