Healthcare Provider Details

I. General information

NPI: 1306575584
Provider Name (Legal Business Name): DR. RICK CRAMER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2022
Last Update Date: 06/06/2022
Certification Date: 06/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

747 FISHBURN RD
HERSHEY PA
17033-2012
US

IV. Provider business mailing address

747 FISHBURN RD
HERSHEY PA
17033-2012
US

V. Phone/Fax

Practice location:
  • Phone: 717-533-7446
  • Fax:
Mailing address:
  • Phone: 717-533-7446
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number027142L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: