Provider Demographics
NPI:1710392014
Name:BRIER, ABIGAIL (DMD)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:BRIER
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 1:1003 TOWAMENCIN AVE
Mailing Address - Street 2:APT E-205
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-5653
Mailing Address - Country:US
Mailing Address - Phone:570-575-6796
Mailing Address - Fax:
Practice Address - Street 1:444 W ARMY TRAIL RD
Practice Address - Street 2:
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-1379
Practice Address - Country:US
Practice Address - Phone:630-387-9764
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-25
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS040052122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1710392014Medicaid