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General NPI Number Information
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NPI Number | 1043512528
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Entity Type | Individual
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Provider Name | ROBERT MICHAEL ABRAHAM JR. DDS
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Gender | Male
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Dates
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Enumeration Date | 12/03/2010
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Last Update Date | 12/03/2010
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Provider Practice Location Address
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Address Line | 440 NORTH LAMAR
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City | OXFORD
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State | MS
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Zip | 38655-5969
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Country | US
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Telephone | 601-720-8194
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Fax | 662-510-0545
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Provider Business Mailing Address
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Address Line | 7000 BLUFF LN
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City | OXFORD
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State | MS
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Zip | 38655-5969
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Country | US
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Telephone | 601-720-8194
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Fax | 662-510-0545
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 2987-97
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License Number State | MS
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