Provider Demographics
NPI:1013587278
Name:SKRMETTA, KRISTAL MARIE (DMD)
Entity Type:Individual
Prefix:DR
First Name:KRISTAL
Middle Name:MARIE
Last Name:SKRMETTA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 COURT ST APT 13
Mailing Address - Street 2:
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431-3457
Mailing Address - Country:US
Mailing Address - Phone:407-301-6362
Mailing Address - Fax:
Practice Address - Street 1:391 WEST ST
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-2409
Practice Address - Country:US
Practice Address - Phone:603-357-0677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-30
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH04659122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist