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General NPI Number Information
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NPI Number | 1386873115
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Entity Type | Individual
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Provider Name | KRISTIN L KRATZER DMD
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Gender | Female
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Dates
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Enumeration Date | 07/14/2009
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Last Update Date | 01/25/2011
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Provider Practice Location Address
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Address Line | 1424 BROADWAY
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City | FOUNTAIN HILL
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State | PA
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Zip | 18015-4025
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Country | US
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Telephone | 610-867-4461
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Fax | 610-867-9354
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Provider Business Mailing Address
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Address Line | 1424 BROADWAY
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City | FOUNTAIN HILL
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State | PA
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Zip | 18015-4025
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Country | US
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Telephone | 610-867-4461
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Fax | 610-867-9354
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 6094
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DS038511
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License Number State | PA
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