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General NPI Number Information
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NPI Number | 1285211557
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Entity Type | Individual
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Provider Name | ABBY RACHEL EISENBERG DDS
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Gender | Female
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Dates
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Enumeration Date | 03/24/2021
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Last Update Date | 07/02/2024
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Provider Practice Location Address
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Address Line | 2201 26TH AVE NW
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City | NEW BRIGHTON
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State | MN
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Zip | 55112-5005
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Country | US
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Telephone | 763-784-7993
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Fax |
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Provider Business Mailing Address
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Address Line | 2201 26TH AVE NW
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City | NEW BRIGHTON
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State | MN
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Zip | 55112-5005
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Country | US
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Telephone | 763-784-7993
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Fax |
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | D14816
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License Number State | MN
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