Provider Demographics
NPI:1194899450
Name:ABRAMSON, MATTHEW M (DDS, MS)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:M
Last Name:ABRAMSON
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:160 BERGAMOT DR
Mailing Address - Street 2:
Mailing Address - City:HAMEL
Mailing Address - State:MN
Mailing Address - Zip Code:55340-4200
Mailing Address - Country:US
Mailing Address - Phone:612-476-9316
Mailing Address - Fax:952-435-0330
Practice Address - Street 1:625 E NICOLLET BLVD
Practice Address - Street 2:STE. 300
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-6734
Practice Address - Country:US
Practice Address - Phone:952-435-0333
Practice Address - Fax:952-435-0330
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN104731223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics