Provider Demographics
NPI:1922315399
Name:ABRAHMSOHN, GLENN MEYER (DDS)
Entity Type:Individual
Prefix:
First Name:GLENN
Middle Name:MEYER
Last Name:ABRAHMSOHN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 CRANDON BLVD.
Mailing Address - Street 2:SUITE 31
Mailing Address - City:KEY BISCAYNE
Mailing Address - State:FL
Mailing Address - Zip Code:33149
Mailing Address - Country:US
Mailing Address - Phone:305-361-0778
Mailing Address - Fax:305-365-0951
Practice Address - Street 1:260 CRANDON BLVD.
Practice Address - Street 2:SUITE 31
Practice Address - City:KEY BISCAYNE
Practice Address - State:FL
Practice Address - Zip Code:33149
Practice Address - Country:US
Practice Address - Phone:305-361-0778
Practice Address - Fax:305-365-0951
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-08
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN9146122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist