Healthcare Provider Details

I. General information

NPI: 1386844231
Provider Name (Legal Business Name): MARK ABRAMSON, D D S INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2007
Last Update Date: 12/02/2022
Certification Date: 12/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

424 N SAN MATEO DR STE 300
SAN MATEO CA
94401-2492
US

IV. Provider business mailing address

35 RENATO CT
REDWOOD CITY CA
94061-4095
US

V. Phone/Fax

Practice location:
  • Phone: 650-369-9227
  • Fax: 650-369-9241
Mailing address:
  • Phone: 650-369-9227
  • Fax: 650-369-9241

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number25856
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. MARK E ABRAMSON
Title or Position: PRESIDENT
Credential: D D S
Phone: 650-369-9227