Provider Demographics
NPI:1780638890
Name:ABBEY, PATRICK A (DMD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:A
Last Name:ABBEY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3000 E FLETCHER AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-4656
Mailing Address - Country:US
Mailing Address - Phone:813-972-4099
Mailing Address - Fax:813-972-4920
Practice Address - Street 1:3000 E. FLETCHER AVE STE 100
Practice Address - Street 2:ORAL & MAXILLOFACIAL SURGERY
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613
Practice Address - Country:US
Practice Address - Phone:813-972-4099
Practice Address - Fax:813-972-4920
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-22
Last Update Date:2016-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN119191223S0112X, 204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL69792Medicare ID - Type Unspecified