Provider Demographics
NPI:1083834790
Name:KAMER, DAVID TODD (DMD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:TODD
Last Name:KAMER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5301 W HWY 146
Mailing Address - Street 2:
Mailing Address - City:CRESTWOOD
Mailing Address - State:KY
Mailing Address - Zip Code:40014-8596
Mailing Address - Country:US
Mailing Address - Phone:502-243-2400
Mailing Address - Fax:502-243-1281
Practice Address - Street 1:5301 W HWY 146
Practice Address - Street 2:
Practice Address - City:CRESTWOOD
Practice Address - State:KY
Practice Address - Zip Code:40014-8596
Practice Address - Country:US
Practice Address - Phone:502-243-2400
Practice Address - Fax:502-243-1281
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY7054122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist