Provider Demographics
NPI:1851747125
Name:KAEMMER, ALLISON (DDS)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:KAEMMER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:
Other - Last Name:OETH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:633 S SAINT MARYS ST UNIT 1202
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78205-3497
Mailing Address - Country:US
Mailing Address - Phone:503-383-8879
Mailing Address - Fax:
Practice Address - Street 1:3145 GARDEN AVE STE 1278
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78234-7719
Practice Address - Country:US
Practice Address - Phone:503-383-8879
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-05
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD10515122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist