MEDICARE: RICHARD LYNN KRANTZ DDS

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	122300000X	Dentist	3767	KY
2	122300000X	Dentist	12008957B	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811978786
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD LYNN KRANTZ DDS

Provider Business Mailing Address
First Line	:	2086 OLD HWY 135
Second Line	:
City	:	CORYDON
State	:	IN
Zip	:	47112
Country	:	US
Telephone Number	:	812-734-1388
Fax Number	:

Provider Business Practice Location Address
First Line	:	4309 COUNTRY VIEW DRIVE
Second Line	:
City	:	FLOYDS KNOBS
State	:	IN
Zip	:	47119
Country	:	US
Telephone Number	:	812-923-6581
Fax Number	:	812-923-6581

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

Provider Enumeration Date	:	11/08/2005
Last Update Date	:	01/18/2008

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