Provider Demographics
NPI:1811192016
Name:ADAM P. CRAMER D.D.S. & ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:ADAM P. CRAMER D.D.S. & ASSOCIATES, P.C.
Other - Org Name:DENTAL CARE OF LACEY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:PHILIP
Authorized Official - Last Name:CRAMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-455-1231
Mailing Address - Street 1:719 SLEATER KINNEY RD SE STE 130
Mailing Address - Street 2:
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98503-1138
Mailing Address - Country:US
Mailing Address - Phone:360-455-1231
Mailing Address - Fax:360-455-1233
Practice Address - Street 1:719 SLEATER KINNEY RD SE STE 130
Practice Address - Street 2:
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98503-1138
Practice Address - Country:US
Practice Address - Phone:360-455-1231
Practice Address - Fax:360-455-1233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE 10599122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty