Provider Demographics
NPI:1295810315
Name:ABERTH, GEORGE HENRY JR (DDS)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:HENRY
Last Name:ABERTH
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:4506 E HIGHWAY 20
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NICEVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32578-9755
Mailing Address - Country:US
Mailing Address - Phone:850-897-1231
Mailing Address - Fax:850-897-4504
Practice Address - Street 1:4506 E HIGHWAY 20
Practice Address - Street 2:SUITE 100
Practice Address - City:NICEVILLE
Practice Address - State:FL
Practice Address - Zip Code:32578-9755
Practice Address - Country:US
Practice Address - Phone:850-897-1231
Practice Address - Fax:850-897-4504
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLDN117591223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics