Provider Demographics
NPI:1376375758
Name:KRAMER, MORGAN DIAMOND (DMD)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:DIAMOND
Last Name:KRAMER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1649 S SAILORS CT
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-0474
Mailing Address - Country:US
Mailing Address - Phone:480-353-7572
Mailing Address - Fax:
Practice Address - Street 1:10850 N 90TH ST
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-6717
Practice Address - Country:US
Practice Address - Phone:480-657-6357
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-15
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD012154122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist