Provider Demographics
NPI:1740873132
Name:KRAMPE, NICHOLAS T (DDS)
Entity type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:T
Last Name:KRAMPE
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 1:6085 9 MILE RD NE
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:MI
Mailing Address - Zip Code:49341-7747
Mailing Address - Country:US
Mailing Address - Phone:616-540-0739
Mailing Address - Fax:
Practice Address - Street 1:1848 E SHERMAN BLVD STE C
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49444-1963
Practice Address - Country:US
Practice Address - Phone:231-737-7745
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-16
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29016005461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice