Provider Demographics
NPI:1831219500
Name:ABAR, HOSS (DDS, MSD)
Entity type:Individual
Prefix:DR
First Name:HOSS
Middle Name:
Last Name:ABAR
Suffix:
Gender:M
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 TARA HILLS DR
Mailing Address - Street 2:SUITE #204
Mailing Address - City:PINOLE
Mailing Address - State:CA
Mailing Address - Zip Code:94564-2577
Mailing Address - Country:US
Mailing Address - Phone:510-724-4746
Mailing Address - Fax:510-724-5117
Practice Address - Street 1:1500 TARA HILLS DR
Practice Address - Street 2:SUITE #204
Practice Address - City:PINOLE
Practice Address - State:CA
Practice Address - Zip Code:94564-2577
Practice Address - Country:US
Practice Address - Phone:510-724-4746
Practice Address - Fax:510-724-5117
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA465421223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics