Provider Demographics
NPI:1972504710
Name:ABBETT, TAMARA KAY (DDS)
Entity Type:Individual
Prefix:DR
First Name:TAMARA
Middle Name:KAY
Last Name:ABBETT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:940 ELLENDALE DR
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-8216
Mailing Address - Country:US
Mailing Address - Phone:541-779-9059
Mailing Address - Fax:541-779-0226
Practice Address - Street 1:940 ELLENDALE DR
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-8216
Practice Address - Country:US
Practice Address - Phone:541-779-9059
Practice Address - Fax:541-779-0226
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-02
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD6842122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist