Provider Demographics
NPI:1720147853
Name:ABBO, BILL (DDS MS)
Entity Type:Individual
Prefix:DR
First Name:BILL
Middle Name:
Last Name:ABBO
Suffix:
Gender:M
Credentials:DDS MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19331 NE 19TH PL
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33179-3611
Mailing Address - Country:US
Mailing Address - Phone:305-710-3129
Mailing Address - Fax:
Practice Address - Street 1:3031 NE 163RD ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160-4462
Practice Address - Country:US
Practice Address - Phone:305-945-0909
Practice Address - Fax:305-945-0907
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901019307122300000X
FLDN177811223P0700X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist
No1223P0700XDental ProvidersDentistProsthodontics