Provider Demographics
NPI:1770709016
Name:KABIL, ABDALLAH EZZAT (DMD)
Entity type:Individual
Prefix:DR
First Name:ABDALLAH
Middle Name:EZZAT
Last Name:KABIL
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 1:917 MACDADE BLVD
Mailing Address - Street 2:
Mailing Address - City:COLLINGDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19023-3719
Mailing Address - Country:US
Mailing Address - Phone:610-583-4443
Mailing Address - Fax:610-583-8413
Practice Address - Street 1:917 MACDADE BLVD
Practice Address - Street 2:
Practice Address - City:COLLINGDALE
Practice Address - State:PA
Practice Address - Zip Code:19023-3719
Practice Address - Country:US
Practice Address - Phone:610-583-4443
Practice Address - Fax:610-583-8413
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS029568-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice