Individual
NABIL A ABAZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
207 N BROAD ST, PHILADELPHIA, PA 19107-1500
(215) 561-0562
(215) 561-0472
Mailing address
1601 CHERRY ST, SUITE 11511, PHILADELPHIA, PA 19102-1321
(215) 255-7822
(215) 255-7825
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DS019318L
PA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
DS019318L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000767939
—
PA
Enumeration date
05/23/2006
Last updated
04/29/2015
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