Healthcare Provider Details

I. General information

NPI: 1104132091
Provider Name (Legal Business Name): KATHERINE L CRAMER D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2010
Last Update Date: 02/11/2025
Certification Date: 02/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 W SAGINAW ST
LANSING MI
48915-1380
US

IV. Provider business mailing address

1500 W SAGINAW ST
LANSING MI
48915-1380
US

V. Phone/Fax

Practice location:
  • Phone: 517-485-8677
  • Fax:
Mailing address:
  • Phone: 517-485-8677
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2901020804
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: