Provider Demographics
NPI:1588814891
Name:KAMMER, CHRISTIAN S (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:S
Last Name:KAMMER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2275 DEMING WAY
Mailing Address - Street 2:#180
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-5527
Mailing Address - Country:US
Mailing Address - Phone:608-827-6453
Mailing Address - Fax:608-824-9927
Practice Address - Street 1:2275 DEMING WAY
Practice Address - Street 2:#180
Practice Address - City:MIDDLETON
Practice Address - State:WI
Practice Address - Zip Code:53562-5527
Practice Address - Country:US
Practice Address - Phone:608-827-6453
Practice Address - Fax:608-824-9927
Is Sole Proprietor?:No
Enumeration Date:2008-09-23
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI28871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice