Provider Demographics
NPI:1730235961
Name:LAURA E KRAUSE & STEPHEN E PALMER PTRS
Entity type:Organization
Organization Name:LAURA E KRAUSE & STEPHEN E PALMER PTRS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:PALMER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:207-772-5244
Mailing Address - Street 1:265 WESTBROOK ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-3327
Mailing Address - Country:US
Mailing Address - Phone:207-772-5244
Mailing Address - Fax:
Practice Address - Street 1:265 WESTBROOK ST
Practice Address - Street 2:
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-3327
Practice Address - Country:US
Practice Address - Phone:207-772-5244
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental