Provider Demographics
NPI:1144434572
Name:KRAMER, GARY ROBERT (DDS09)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:ROBERT
Last Name:KRAMER
Suffix:
Gender:M
Credentials:DDS09
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5631 BURKE CENTRE PKWY STE F
Mailing Address - Street 2:F
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-2234
Mailing Address - Country:US
Mailing Address - Phone:703-978-0051
Mailing Address - Fax:703-978-0685
Practice Address - Street 1:5631 BURKE CENTRE PKWY STE F
Practice Address - Street 2:F
Practice Address - City:BURKE
Practice Address - State:VA
Practice Address - Zip Code:22015-2234
Practice Address - Country:US
Practice Address - Phone:703-978-0051
Practice Address - Fax:703-978-0685
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA062161223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry