Provider Demographics
NPI:1760722888
Name:ABERTH, GEORGE ZACHARY (DDS)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:ZACHARY
Last Name:ABERTH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1773 OSPREY CV
Mailing Address - Street 2:
Mailing Address - City:NICEVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32578-6812
Mailing Address - Country:US
Mailing Address - Phone:850-960-5176
Mailing Address - Fax:
Practice Address - Street 1:908 PALM BLVD S STE B
Practice Address - Street 2:
Practice Address - City:NICEVILLE
Practice Address - State:FL
Practice Address - Zip Code:32578-2603
Practice Address - Country:US
Practice Address - Phone:850-729-1223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-26
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN20187122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist