Provider Demographics
NPI:1821168006
Name:KREMER, KEVIN D (DDS)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:D
Last Name:KREMER
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 1:3 GLENBROOK CT
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95973-5402
Mailing Address - Country:US
Mailing Address - Phone:530-892-1234
Mailing Address - Fax:530-892-1272
Practice Address - Street 1:3 GLENBROOK CT
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973-5402
Practice Address - Country:US
Practice Address - Phone:530-892-1234
Practice Address - Fax:530-892-1272
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2009-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA444141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice