Provider Demographics
NPI:1922211994
Name:KEITH M. ABE DDS INC.
Entity Type:Organization
Organization Name:KEITH M. ABE DDS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:M
Authorized Official - Last Name:ABE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:650-961-4492
Mailing Address - Street 1:485 SOUTH DR
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-4202
Mailing Address - Country:US
Mailing Address - Phone:650-961-4492
Mailing Address - Fax:650-745-4144
Practice Address - Street 1:485 SOUTH DR
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-4202
Practice Address - Country:US
Practice Address - Phone:650-961-4492
Practice Address - Fax:650-745-4144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA382421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty