Provider Demographics
NPI:1225423189
Name:KEITH A ABRAMS DMD PA
Entity type:Organization
Organization Name:KEITH A ABRAMS DMD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:ABRAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:973-773-3741
Mailing Address - Street 1:1100 CLIFTON AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-3631
Mailing Address - Country:US
Mailing Address - Phone:973-773-3741
Mailing Address - Fax:973-778-2068
Practice Address - Street 1:1100 CLIFTON AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-3631
Practice Address - Country:US
Practice Address - Phone:973-773-3741
Practice Address - Fax:973-778-2068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-30
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ31661223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty