Provider Demographics
NPI:1962074187
Name:KRAMER, MICHELE
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:KRAMER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11915 KLING ST APT 9
Mailing Address - Street 2:
Mailing Address - City:VALLEY VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91607-4041
Mailing Address - Country:US
Mailing Address - Phone:818-740-1905
Mailing Address - Fax:
Practice Address - Street 1:1633 S ALAMEDA ST
Practice Address - Street 2:
Practice Address - City:COMPTON
Practice Address - State:CA
Practice Address - Zip Code:90220-4976
Practice Address - Country:US
Practice Address - Phone:310-627-5600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-15
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant