MEDICARE: DR. GARY CRAMER III DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DS040429	PA

General Provider Information

NPI Number	:	1275915076
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GARY CRAMER III DMD

Provider Business Mailing Address
First Line	:	687 UNIONVILLE RD
Second Line	:
City	:	KENNETT SQUARE
State	:	PA
Zip	:	19348-4717
Country	:	US
Telephone Number	:	610-444-0750
Fax Number	:	610-444-3835

Provider Business Practice Location Address
First Line	:	687 UNIONVILLE RD
Second Line	:
City	:	KENNETT SQUARE
State	:	PA
Zip	:	19348-4717
Country	:	US
Telephone Number	:	610-444-0750
Fax Number	:	610-444-3835

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/29/2015
Last Update Date	:	06/29/2015

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