Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 11773 | GA |
NPI | 1073691267 |
---|---|
Provider Name | Dr. Narisa A. Cramer |
First Address | Acworth, GA 30101-4104 |
Second Address | Acworth, GA 30101-4104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2006 |
Last Update Date | 16/10/2020 |