Provider Demographics
NPI:1437303831
Name:ABRAMSON, CAILYN XIA GONG (DMD)
Entity Type:Individual
Prefix:MRS
First Name:CAILYN
Middle Name:XIA GONG
Last Name:ABRAMSON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2029 VALLEYGATE DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-3771
Mailing Address - Country:US
Mailing Address - Phone:910-485-8884
Mailing Address - Fax:910-485-8287
Practice Address - Street 1:10 BRICKHAM WAY
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:CT
Practice Address - Zip Code:06013-2630
Practice Address - Country:US
Practice Address - Phone:860-888-2362
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-12
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9189122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5919606Medicaid