Individual provider · NPI-1

Bruce Shintaro Abe, D.D.S.

Dentist, Periodontics · San Diego, CA

NPI number1235104688
StatusActive
Last updated in NPPESSep 25, 2023

Details

NPI
1235104688
Entity type
Individual (NPI-1)
Name
Bruce Shintaro Abe
Credential
D.D.S.
Sex
Male
Sole proprietor
No
Enumeration date
Feb 21, 2006
Certification date
Sep 24, 2023
Last updated
Sep 25, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223P0300X Dentist, Periodontics47344CAYes

Practice location

501 Washington St Ste 740
San Diego, CA 92103-2231

Phone 619-393-7511

Mailing address

501 Washington St Ste 740
San Diego, CA 92103-2231

Phone 619-417-9910

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