Individual
DR. ABUBAKER OMAR ABUBAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
B.D.S. DMD, PHD
Contact information
Practice address
520 N 12TH ST, RICHMOND, VA 23219-1610
(804) 828-4249
Mailing address
521 N 11TH ST, P O BOX 980566, RICHMOND, VA 23298-5045
(804) 828-4249
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
040100835
VA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
0401008355
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010036488
—
VA
Enumeration date
04/10/2006
Last updated
07/25/2019
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