Provider Demographics
NPI:1538275367
Name:ABERCROMBIE, GARY DON (DDS)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:DON
Last Name:ABERCROMBIE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 W 24TH ST
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:79072-1853
Mailing Address - Country:US
Mailing Address - Phone:806-293-4284
Mailing Address - Fax:806-293-9537
Practice Address - Street 1:2801 W 24TH ST
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:TX
Practice Address - Zip Code:79072-1853
Practice Address - Country:US
Practice Address - Phone:806-293-4284
Practice Address - Fax:806-293-9537
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX113011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice