Provider Demographics
NPI:1518371301
Name:GREGORY R ABRAMS, DMD IV, PA
Entity Type:Organization
Organization Name:GREGORY R ABRAMS, DMD IV, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:R
Authorized Official - Last Name:ABRAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:704-237-4202
Mailing Address - Street 1:2315 PENDER PL
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28209-1726
Mailing Address - Country:US
Mailing Address - Phone:704-237-4202
Mailing Address - Fax:704-237-4263
Practice Address - Street 1:2315 PENDER PL
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28209-1726
Practice Address - Country:US
Practice Address - Phone:704-237-4202
Practice Address - Fax:704-237-4263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-19
Last Update Date:2014-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty