Provider Demographics
NPI:1639277700
Name:GRAHAM-KREMERS, AMA D (DDS)
Entity Type:Individual
Prefix:DR
First Name:AMA
Middle Name:D
Last Name:GRAHAM-KREMERS
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 1:100 N HANOVER ST
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17013-2421
Mailing Address - Country:US
Mailing Address - Phone:717-218-6670
Mailing Address - Fax:717-218-6671
Practice Address - Street 1:100 N HANOVER ST
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17013-2421
Practice Address - Country:US
Practice Address - Phone:717-218-6670
Practice Address - Fax:717-218-6671
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS036878122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007543070048Medicaid
PA1017665810003Medicaid
PA1017665810012Medicaid
PA1017665810016Medicaid
PA1017665810002Medicaid
PA1017665810001Medicaid
PA1017665810015Medicaid
PA1017665810010Medicaid
PA1017665810011Medicaid
PA1007543070009Medicaid
PA1017665810013Medicaid
PA1017665810014Medicaid