Provider Demographics
NPI:1336366418
Name:ABRIOL, NICASIO MACARAEG JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:NICASIO
Middle Name:MACARAEG
Last Name:ABRIOL
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3068 STORY RD
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95127-3934
Mailing Address - Country:US
Mailing Address - Phone:408-259-0458
Mailing Address - Fax:408-729-0559
Practice Address - Street 1:3068 STORY RD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95127-3934
Practice Address - Country:US
Practice Address - Phone:408-259-0458
Practice Address - Fax:408-729-0559
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA433011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice