Healthcare Provider Details
I. General information
NPI: 1194296491
Provider Name (Legal Business Name): KRAMER DENTISTRY INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/12/2018
Last Update Date: 05/24/2023
Certification Date: 05/24/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9290 HIGHLAND RIDGE HEIGHTS SUITE # 120
COLORADO SPRINGS CO
80920
US
IV. Provider business mailing address
920 CARLSON DR
COLORADO SPRINGS CO
80919-3917
US
V. Phone/Fax
- Phone: 719-964-3388
- Fax:
- Phone: 719-964-3388
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QD0000X |
| Taxonomy | Dental Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JOHN
C
KRAMER
Title or Position: CEO/FOUNDER
Credential: DDS
Phone: 719-964-3388