Provider Demographics
NPI:1780752386
Name:ABREW, JOSEPH JOEL (DDS)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:JOEL
Last Name:ABREW
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 1:290 ALAMO DR STE A
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95688-4245
Mailing Address - Country:US
Mailing Address - Phone:707-446-2036
Mailing Address - Fax:707-446-4211
Practice Address - Street 1:290 ALAMO DR STE A
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95688-4245
Practice Address - Country:US
Practice Address - Phone:707-446-2036
Practice Address - Fax:707-446-4211
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47220122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist