Provider Demographics
NPI:1447456488
Name:KREMSER, MATTHEW (DDS)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:
Last Name:KREMSER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9150 MARKET SQUARE DR
Mailing Address - Street 2:SUITE NUMBER 103
Mailing Address - City:STREETSBORO
Mailing Address - State:OH
Mailing Address - Zip Code:44241-4571
Mailing Address - Country:US
Mailing Address - Phone:330-626-9090
Mailing Address - Fax:330-626-9730
Practice Address - Street 1:9150 MARKET SQUARE DR
Practice Address - Street 2:SUITE NUMBER 103
Practice Address - City:STREETSBORO
Practice Address - State:OH
Practice Address - Zip Code:44241-4571
Practice Address - Country:US
Practice Address - Phone:330-626-9090
Practice Address - Fax:330-626-9730
Is Sole Proprietor?:No
Enumeration Date:2007-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0213971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice