Healthcare Provider Details

I. General information

NPI: 1003800061
Provider Name (Legal Business Name): ORAL AND FACIAL SURGERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1102 SHELLER AVE
CHAMBERSBURG PA
17201-2974
US

IV. Provider business mailing address

1102 SHELLER AVE
CHAMBERSBURG PA
17201-2974
US

V. Phone/Fax

Practice location:
  • Phone: 717-264-7828
  • Fax: 717-264-4089
Mailing address:
  • Phone: 717-264-7828
  • Fax: 717-264-4089

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: DR. RICHARD EDWARD KRAMER
Title or Position: PRESIDENT
Credential: DDS
Phone: 301-791-1700