# ABBEVILLE DENTISTRY - LUBBOCK PUEBLO, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lubbock Salem Ave
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356092324
- **Authorized official:** JEFF REIBEL (CFO)
- **Authorized official phone:** (502) 254-8500

## Contact information

- **Practice address:** 5102 SALEM AVE, LUBBOCK, TX 79414-4036
- **Practice address phone:** (502) 254-8500
- **Mailing address:** PO BOX 437169, LOUISVILLE, KY 40253-7169
- **Mailing address phone:** (502) 254-8500

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 01/12/2022
- **Last updated:** 08/17/2022