Provider Demographics
NPI:1588719546
Name:ABRAMSON, MARC AARON (DDS)
Entity type:Individual
Prefix:DR
First Name:MARC
Middle Name:AARON
Last Name:ABRAMSON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:MARC
Other - Middle Name:
Other - Last Name:ABRAMSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:589 BEULAH HWY
Mailing Address - Street 2:
Mailing Address - City:BEULAH
Mailing Address - State:MI
Mailing Address - Zip Code:49617-8708
Mailing Address - Country:US
Mailing Address - Phone:231-882-4424
Mailing Address - Fax:231-882-4450
Practice Address - Street 1:589 BEULAH HWY
Practice Address - Street 2:
Practice Address - City:BEULAH
Practice Address - State:MI
Practice Address - Zip Code:49617-8708
Practice Address - Country:US
Practice Address - Phone:231-882-4424
Practice Address - Fax:231-882-4450
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2020-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI290101152122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist