Provider Demographics
NPI:1083849582
Name:KRAMER, RICHARD STEWART (DMD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:STEWART
Last Name:KRAMER
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 1:2050 NE DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:JENSEN BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:34957-6441
Mailing Address - Country:US
Mailing Address - Phone:772-334-1965
Mailing Address - Fax:723-341-9667
Practice Address - Street 1:2050 NE DIXIE HWY
Practice Address - Street 2:
Practice Address - City:JENSEN BEACH
Practice Address - State:FL
Practice Address - Zip Code:34957-6441
Practice Address - Country:US
Practice Address - Phone:772-334-1965
Practice Address - Fax:772-334-1966
Is Sole Proprietor?:No
Enumeration Date:2009-05-28
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN156841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice