Provider Demographics
NPI:1447788724
Name:KRAMER, KATIE MARIE (DDS)
Entity Type:Individual
Prefix:DR
First Name:KATIE
Middle Name:MARIE
Last Name:KRAMER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 MAIN STREET SENECA DENTAL PA
Mailing Address - Street 2:
Mailing Address - City:SENECA
Mailing Address - State:KS
Mailing Address - Zip Code:66538-1926
Mailing Address - Country:US
Mailing Address - Phone:785-336-6149
Mailing Address - Fax:785-336-0050
Practice Address - Street 1:430 MAIN ST
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:KS
Practice Address - Zip Code:66538-1926
Practice Address - Country:US
Practice Address - Phone:785-336-6149
Practice Address - Fax:785-336-0050
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-31
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS613901223G0001X, 261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No1223G0001XDental ProvidersDentistGeneral Practice