Provider Demographics
NPI:1336555804
Name:ABD, SENAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:SENAN
Middle Name:
Last Name:ABD
Suffix:
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 1:1609 MAPLELEAF DR
Mailing Address - Street 2:
Mailing Address - City:WYLIE
Mailing Address - State:TX
Mailing Address - Zip Code:75098-8165
Mailing Address - Country:US
Mailing Address - Phone:909-223-4035
Mailing Address - Fax:
Practice Address - Street 1:200 CYPRESS BEND PKWY
Practice Address - Street 2:BUILDING A ,SUITE 3
Practice Address - City:PRINCETON
Practice Address - State:TX
Practice Address - Zip Code:75407
Practice Address - Country:US
Practice Address - Phone:469-290-6565
Practice Address - Fax:469-290-6566
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-06
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX300801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice