Provider Demographics
NPI:1003800061
Name:ORAL AND FACIAL SURGERY
Entity Type:Organization
Organization Name:ORAL AND FACIAL SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:KRAMER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-791-1700
Mailing Address - Street 1:1102 SHELLER AVE
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-2974
Mailing Address - Country:US
Mailing Address - Phone:717-264-7828
Mailing Address - Fax:717-264-4089
Practice Address - Street 1:1102 SHELLER AVE
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-2974
Practice Address - Country:US
Practice Address - Phone:717-264-7828
Practice Address - Fax:717-264-4089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA715347Medicare ID - Type Unspecified