Provider Demographics
NPI:1265641450
Name:ABRAMS, ALAN STEPHEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:STEPHEN
Last Name:ABRAMS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 FAWN RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851-1140
Mailing Address - Country:US
Mailing Address - Phone:203-856-6697
Mailing Address - Fax:
Practice Address - Street 1:148 EAST AVE
Practice Address - Street 2:SUITE 1-C
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-5721
Practice Address - Country:US
Practice Address - Phone:203-866-2010
Practice Address - Fax:203-855-9220
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4925122300000X
CT004938124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered122300000XDental ProvidersDentist
Not Answered124Q00000XDental ProvidersDental Hygienist