Provider Demographics
NPI:1306012794
Name:ABRAMSON, ERNEST FRED (DMD)
Entity Type:Individual
Prefix:DR
First Name:ERNEST
Middle Name:FRED
Last Name:ABRAMSON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4456 NATURAL BRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63115-2627
Mailing Address - Country:US
Mailing Address - Phone:314-383-3434
Mailing Address - Fax:314-383-5501
Practice Address - Street 1:4456 NATURAL BRIDGE AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63115-2627
Practice Address - Country:US
Practice Address - Phone:314-383-3434
Practice Address - Fax:314-383-5501
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-05
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO12782122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist