| Organization Name: | RUTH A ABRAHAM D.D.S. P.C. |
| NPI Number: | 1164606778 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RUTH ANN ABRAHAM (OWNER) |
| Mailing Address: | 3857 River Rd N Keizer |
| State: | OR US |
| Postal Code: | 973034803 |
| Phone Number: | 5033901100 |
| Fax Number: | 5033904455 |
| NPI Enumeration Date: | 12/19/2007 |
| NPI Last Update Date: | 12/19/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |