Provider Demographics
NPI:1639281660
Name:KRAMER, PHILIP D JR (DDS)
Entity Type:Individual
Prefix:MR
First Name:PHILIP
Middle Name:D
Last Name:KRAMER
Suffix:JR
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:P. O. BOX 767
Mailing Address - Street 2:
Mailing Address - City:WELSH
Mailing Address - State:LA
Mailing Address - Zip Code:70591
Mailing Address - Country:US
Mailing Address - Phone:337-734-3418
Mailing Address - Fax:
Practice Address - Street 1:1333 OAK PARK BLVD.
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-8845
Practice Address - Country:US
Practice Address - Phone:337-478-2960
Practice Address - Fax:337-478-2964
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1848122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist