Provider Demographics
NPI:1780041228
Name:LORNA ABDON D.M.D. INC.
Entity Type:Organization
Organization Name:LORNA ABDON D.M.D. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LORNA
Authorized Official - Middle Name:AGBANGLO
Authorized Official - Last Name:ABDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-595-8553
Mailing Address - Street 1:1414 W WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90810-3119
Mailing Address - Country:US
Mailing Address - Phone:562-595-8553
Mailing Address - Fax:562-595-9123
Practice Address - Street 1:1414 W WILLOW ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90810-3119
Practice Address - Country:US
Practice Address - Phone:562-595-8553
Practice Address - Fax:562-595-9123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-27
Last Update Date:2016-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39936261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental