Provider Demographics
NPI:1295950863
Name:ABRAMS, KEITH ANDREW (DMD)
Entity type:Individual
Prefix:DR
First Name:KEITH
Middle Name:ANDREW
Last Name:ABRAMS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 CLIFTON AVE
Mailing Address - Street 2:E
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:E
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
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ139971223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics