Provider Demographics
NPI:1790888154
Name:S ANDRES ABUSLEME DDS INC
Entity Type:Organization
Organization Name:S ANDRES ABUSLEME DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SALIM
Authorized Official - Middle Name:ANDRES
Authorized Official - Last Name:ABUSLEME
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:510-215-7944
Mailing Address - Street 1:243 CIVIC CENTER ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94804-1816
Mailing Address - Country:US
Mailing Address - Phone:510-215-7944
Mailing Address - Fax:510-215-1482
Practice Address - Street 1:243 CIVIC CENTER ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94804-1816
Practice Address - Country:US
Practice Address - Phone:510-215-7944
Practice Address - Fax:510-215-1482
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37073122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA37073-1OtherDENTICAL