Provider Demographics
NPI:1942305560
Name:ROMANOWSKY, ABRAHAM E (DDS)
Entity Type:Individual
Prefix:
First Name:ABRAHAM
Middle Name:E
Last Name:ROMANOWSKY
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 1:7817 IVANHOE AVE
Mailing Address - Street 2:SUITE 305
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037
Mailing Address - Country:US
Mailing Address - Phone:858-454-3043
Mailing Address - Fax:858-454-6410
Practice Address - Street 1:7817 IVANHOE AVE
Practice Address - Street 2:SUITE 305
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037
Practice Address - Country:US
Practice Address - Phone:858-454-3043
Practice Address - Fax:858-454-6410
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA353251223G0001X, 1223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1223G0001XDental ProvidersDentistGeneral Practice
Not Answered1223P0700XDental ProvidersDentistProsthodontics