Provider Demographics
NPI:1013321017
Name:KRAMER, KATHRYN ELIZABETH (DDS)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:ELIZABETH
Last Name:KRAMER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 BAKER PARK RD
Mailing Address - Street 2:SUITE 1040
Mailing Address - City:MAPLE PLAIN
Mailing Address - State:MN
Mailing Address - Zip Code:55359-9851
Mailing Address - Country:US
Mailing Address - Phone:763-402-7003
Mailing Address - Fax:763-447-3208
Practice Address - Street 1:1400 BAKER PARK RD
Practice Address - Street 2:SUITE 1040
Practice Address - City:MAPLE PLAIN
Practice Address - State:MN
Practice Address - Zip Code:55359-9851
Practice Address - Country:US
Practice Address - Phone:763-402-7003
Practice Address - Fax:763-447-3208
Is Sole Proprietor?:No
Enumeration Date:2014-06-17
Last Update Date:2016-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND134261223G0001X
NE71441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice