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General NPI Number Information
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NPI Number | 1194899450
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Entity Type | Individual
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Provider Name | MATTHEW M. ABRAMSON DDS, MS
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Gender | Male
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Dates
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Enumeration Date | 11/20/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 625 E NICOLLET BLVD STE. 300
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City | BURNSVILLE
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State | MN
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Zip | 55337-6734
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Country | US
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Telephone | 952-435-0333
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Fax | 952-435-0330
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Provider Business Mailing Address
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Address Line | 160 BERGAMOT DR
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City | HAMEL
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State | MN
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Zip | 55340-4200
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Country | US
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Telephone | 612-476-9316
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Fax | 952-435-0330
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 10473
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License Number State | MN
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