Provider Demographics
NPI:1396913208
Name:DARENSBURG, ABDEL HASSAN (DDS)
Entity type:Individual
Prefix:DR
First Name:ABDEL
Middle Name:HASSAN
Last Name:DARENSBURG
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:PO BOX 547
Mailing Address - Street 2:
Mailing Address - City:LITTLE RIVER
Mailing Address - State:SC
Mailing Address - Zip Code:29566-0547
Mailing Address - Country:US
Mailing Address - Phone:843-663-1013
Mailing Address - Fax:843-663-1017
Practice Address - Street 1:1240 HIGHWAY 17 S
Practice Address - Street 2:
Practice Address - City:NORTH MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29582-3707
Practice Address - Country:US
Practice Address - Phone:843-663-1013
Practice Address - Fax:843-663-1017
Is Sole Proprietor?:No
Enumeration Date:2008-02-13
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053774122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist