Provider Demographics
NPI:1891709945
Name:KRAMER, JOHN E (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:E
Last Name:KRAMER
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 1:9447 WINTER GARDENS BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKESIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92040-4540
Mailing Address - Country:US
Mailing Address - Phone:619-443-3948
Mailing Address - Fax:619-443-3938
Practice Address - Street 1:9447 WINTER GARDENS BLVD
Practice Address - Street 2:
Practice Address - City:LAKESIDE
Practice Address - State:CA
Practice Address - Zip Code:92040-4540
Practice Address - Country:US
Practice Address - Phone:619-443-3948
Practice Address - Fax:619-443-3938
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA220841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice