Individual
JONATHAN ABAEV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
909 WALNUT ST FL 3, PHILADELPHIA, PA 19107-5211
(215) 955-6215
Mailing address
8414 MIDLAND PKWY, JAMAICA, NY 11432-2219
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
22DI02858000
NJ
122300000X
Dentist
Primary
DS044036
PA
Other
Enumeration date
08/18/2021
Last updated
05/10/2023
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