Provider Demographics
NPI:1619125804
Name:G ROSS ABRAMS DMD
Entity Type:Organization
Organization Name:G ROSS ABRAMS DMD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SAWNSURAE
Authorized Official - Middle Name:
Authorized Official - Last Name:HAKIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-405-5690
Mailing Address - Street 1:591 RIVER HWY STE M
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-6979
Mailing Address - Country:US
Mailing Address - Phone:704-235-6075
Mailing Address - Fax:704-235-6076
Practice Address - Street 1:591 RIVER HWY STE M
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-6979
Practice Address - Country:US
Practice Address - Phone:704-235-6075
Practice Address - Fax:704-235-6076
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RON COHEN DDS & ASSOCIATES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-09-03
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC75281223G0001X
NC82431223G0001X
NC83391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty