Provider Demographics
NPI:1043260003
Name:CRAMER, SIDNEY VAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:SIDNEY
Middle Name:VAN
Last Name:CRAMER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1142 KERPER ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19111-4926
Mailing Address - Country:US
Mailing Address - Phone:215-742-5000
Mailing Address - Fax:
Practice Address - Street 1:1142 KERPER ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19111-4926
Practice Address - Country:US
Practice Address - Phone:215-742-5000
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADSO18781L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice