Provider Demographics
NPI:1043547292
Name:KURT E PRAMUK, DDS, PC
Entity Type:Organization
Organization Name:KURT E PRAMUK, DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KURT
Authorized Official - Middle Name:E
Authorized Official - Last Name:PRAMUK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:219-836-2022
Mailing Address - Street 1:9201 CALUMET AVE
Mailing Address - Street 2:
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-2807
Mailing Address - Country:US
Mailing Address - Phone:219-836-2022
Mailing Address - Fax:219-836-0034
Practice Address - Street 1:931 RIDGE RD
Practice Address - Street 2:SUITE C
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-1755
Practice Address - Country:US
Practice Address - Phone:219-236-2226
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-09
Last Update Date:2009-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty