Organization
ABRAHAM DENTAL WINONA, PLLC
Active
Other names
Harrison Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT MICHAEL ABRAHAM JR. DDS (OWNER)
(601) 720-8194
Entity
Organization
Contact information
Practice address
412 TYLER HOLMES DR, WINONA, MS 38967-1522
(662) 283-4722
Mailing address
PO BOX 676, CALHOUN CITY, MS 38916-0676
(601) 720-8194
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2987-97
STATE BOARD
MS
Enumeration date
03/02/2023
Last updated
03/02/2023
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