Healthcare Provider Details

I. General information

NPI: 1235193947
Provider Name (Legal Business Name): LAURIE BETH ABRAMS D.M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9827 W TROPICANA AVE
LAS VEGAS NV
89147-8175
US

IV. Provider business mailing address

9869 MASTERFUL DR
LAS VEGAS NV
89148-4535
US

V. Phone/Fax

Practice location:
  • Phone: 702-740-5437
  • Fax: 702-796-5437
Mailing address:
  • Phone: 702-796-1985
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberS643
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: