Provider Demographics
NPI:1134393747
Name:DRS.KRANER AND KRANER , LLC
Entity type:Organization
Organization Name:DRS.KRANER AND KRANER , LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER, LLC
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:J
Authorized Official - Last Name:KRANER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:636-887-3005
Mailing Address - Street 1:1838 WENTZVILLE PKWY
Mailing Address - Street 2:
Mailing Address - City:WENTZVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63385-3817
Mailing Address - Country:US
Mailing Address - Phone:636-887-3005
Mailing Address - Fax:636-327-3767
Practice Address - Street 1:1838 WENTZVILLE PKWY
Practice Address - Street 2:
Practice Address - City:WENTZVILLE
Practice Address - State:MO
Practice Address - Zip Code:63385-3817
Practice Address - Country:US
Practice Address - Phone:636-887-3005
Practice Address - Fax:636-327-3767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-15
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20060154571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty