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General NPI Number Information
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NPI Number | 1538533989
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Entity Type | Organization
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Legal Business Name | DEREK ABRAMOWSKI DDS
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Dates
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Enumeration Date | 11/23/2015
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Last Update Date | 11/23/2015
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Provider Practice Location Address
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Address Line | 201 SANDBERG RD
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City | MONTICELLO
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State | MN
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Zip | 55362-8906
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Country | US
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Telephone | 763-295-5400
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Fax | 763-295-1785
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Provider Business Mailing Address
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Address Line | 201 SANDBERG RD
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City | MONTICELLO
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State | MN
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Zip | 55362-8906
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Country | US
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Telephone | 763-295-5400
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Fax | 763-295-1785
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Authorized Official
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Title or Position | OWNER
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Name | DR. DEREK DANIEL ABRAMOWSKI
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Credential | D.D.S.
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Telephone | 763-229-2613
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | D13279
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License Number State | MN
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