# JASON M. KUESTER DDS, LLC

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

## Provider details

- **NPI number:** 1255752663
- **Authorized official:** MRS. BRYN E DANT (DENTAL ASSISTANT/OFFICE ASSISTANT)
- **Authorized official phone:** (812) 867-6428

## Contact information

- **Practice address:** 1331 W BOONVILLE NEW HARMONY RD, EVANSVILLE, IN 47725-9583
- **Practice address phone:** (812) 867-6428
- **Practice address fax:** (812) 867-7494
- **Mailing address:** 1331 W BOONVILLE NEW HARMONY RD, EVANSVILLE, IN 47725-9583
- **Mailing address phone:** (812) 867-6428
- **Mailing address fax:** (812) 867-7494

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 12011322-A | IN | Yes |

## Other

- **Enumeration date:** 01/02/2014
- **Last updated:** 01/02/2014