1326271578 NPI number — DR. CHARLES A ABBICK III D.D.S.

Table of content: DR. CHARLES A ABBICK III D.D.S. (NPI 1326271578)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326271578 NPI number — DR. CHARLES A ABBICK III D.D.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ABBICK
Provider First Name:
CHARLES
Provider Middle Name:
A
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
III
Provider Credential Text:
D.D.S.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326271578
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/31/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
625 E NORTH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SALINA
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
67401-2446
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
785-826-1546
Provider Business Mailing Address Fax Number:
785-826-9161

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
625 E NORTH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SALINA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67401-2446
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-826-1546
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/03/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  60678 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 122300000X , with the licence number: 2009014030 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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