Provider Demographics
NPI:1821030966
Name:KRASNER, PAUL ROBERT (DDS)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:ROBERT
Last Name:KRASNER
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 1:18 S ROLAND ST
Mailing Address - Street 2:
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19464-5836
Mailing Address - Country:US
Mailing Address - Phone:610-327-4646
Mailing Address - Fax:610-327-3234
Practice Address - Street 1:18 S ROLAND ST
Practice Address - Street 2:
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19464-5836
Practice Address - Country:US
Practice Address - Phone:610-327-4646
Practice Address - Fax:610-327-3234
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAK19747131223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA153409OtherUNITED CONCORDIA ID #