Provider Demographics
NPI:1932302106
Name:ABATE, MARTIN SCOTT (DDS)
Entity Type:Individual
Prefix:
First Name:MARTIN
Middle Name:SCOTT
Last Name:ABATE
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 1:1819 POLK ST
Mailing Address - Street 2:#339
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109
Mailing Address - Country:US
Mailing Address - Phone:415-989-1001
Mailing Address - Fax:415-989-4349
Practice Address - Street 1:3637 SACRAMENTO ST
Practice Address - Street 2:#C
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118
Practice Address - Country:US
Practice Address - Phone:415-989-1001
Practice Address - Fax:415-989-4349
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37767122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist