Healthcare Provider Details

I. General information

NPI: 1053310664
Provider Name (Legal Business Name): BRUCE JOHN KRAMPER DDS, PC
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/15/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

999 N PLAZA DR STE 210
SCHAUMBURG IL
60173-6022
US

IV. Provider business mailing address

999 N PLAZA DR STE 210
SCHAUMBURG IL
60173-6022
US

V. Phone/Fax

Practice location:
  • Phone: 847-706-9135
  • Fax: 847-706-9119
Mailing address:
  • Phone: 847-706-9135
  • Fax: 847-706-9119

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: