Provider Demographics
NPI:1306032602
Name:WILLIAM R KREMERS, DDS, PC
Entity Type:Organization
Organization Name:WILLIAM R KREMERS, DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:RUSSELL
Authorized Official - Last Name:KREMERS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:913-432-3112
Mailing Address - Street 1:5830 NALL AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66202-2730
Mailing Address - Country:US
Mailing Address - Phone:913-432-3112
Mailing Address - Fax:913-432-5467
Practice Address - Street 1:5830 NALL AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:MISSION
Practice Address - State:KS
Practice Address - Zip Code:66202-2730
Practice Address - Country:US
Practice Address - Phone:913-432-3112
Practice Address - Fax:913-432-5467
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-20
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS57251223G0001X
KS600751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty