# DR. CHARLES J. KRUSA, D.D.S.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134312226
- **Authorized official:** DR. CHARLES JOSEPH KRUSA D.D.S. (DENTIST)
- **Authorized official phone:** (931) 484-3664

## Contact information

- **Practice address:** 289 HIGHLAND SQ, CROSSVILLE, TN 38555-5105
- **Practice address phone:** (931) 484-3664
- **Practice address fax:** (931) 707-5640
- **Mailing address:** 289 HIGHLAND SQ, CROSSVILLE, TN 38555-5105
- **Mailing address phone:** (931) 484-3664
- **Mailing address fax:** (931) 707-5640

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | DS2393 | TN | Yes |

## Other

- **Enumeration date:** 08/22/2007
- **Last updated:** 08/22/2007