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General NPI Number Information
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NPI Number | 1497090914
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Entity Type | Organization
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Legal Business Name | KRAMER FAMILY DENTAL INC
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Dates
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Enumeration Date | 12/10/2012
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Last Update Date | 12/10/2012
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Provider Practice Location Address
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Address Line | 968 W 3RD ST SUITE 250
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City | DUBUQUE
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State | IA
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Zip | 52001-6606
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Country | US
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Telephone | 563-556-3468
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Fax | 563-556-1373
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Provider Business Mailing Address
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Address Line | 968 W 3RD ST SUITE 250
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City | DUBUQUE
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State | IA
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Zip | 52001-6606
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Country | US
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Telephone | 563-556-3468
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Fax | 563-556-1373
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Authorized Official
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Title or Position | DENTIST OWNER OF CORPORATION
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Name | DR. ANNA MARIE MILLER
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Credential | D.M.D
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Telephone | 563-556-3468
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 08466
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License Number State | IA
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