Provider Demographics
NPI:1497090914
Name:KRAMER FAMILY DENTAL INC
Entity Type:Organization
Organization Name:KRAMER FAMILY DENTAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST OWNER OF CORPORATION
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:563-556-3468
Mailing Address - Street 1:968 W 3RD ST
Mailing Address - Street 2:SUITE 250
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52001-6606
Mailing Address - Country:US
Mailing Address - Phone:563-556-3468
Mailing Address - Fax:563-556-1373
Practice Address - Street 1:968 W 3RD ST
Practice Address - Street 2:SUITE 250
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-6606
Practice Address - Country:US
Practice Address - Phone:563-556-3468
Practice Address - Fax:563-556-1373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-10
Last Update Date:2012-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA08466122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty