=====================================================
General NPI Number Information
=====================================================
NPI Number | 1538277348
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KAREN LORRAINE KRAMER DDS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/29/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6156 ST ANDREWS RD SUITE 102
-----------------------------------------------------
City | COLUMBIA
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29212
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 803-731-5155
-----------------------------------------------------
Fax | 803-750-9967
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6156 ST ANDREWS RD SUITE 102
-----------------------------------------------------
City | COLUMBIA
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29212
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 803-731-5155
-----------------------------------------------------
Fax | 803-750-9967
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number | 2930
-----------------------------------------------------
License Number State | SC
-----------------------------------------------------