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Organization
DANIEL W KRUEGER AAS PC
Active
Organization
DANIEL W KRUEGER AAS PC
Active
Other names
LifeSmiles Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL W KRUEGER DDS (OWNER PRESIDENT)
(765) 743-3779
Entity
Organization
Contact information
Practice address
928 N ROBINSON, LIFESMILE DENTISTRY, WEST LAFAYETTE, IN 47906-2766
(765) 743-3779
(765) 743-8767
Mailing address
928 N ROBINSON, WEST LAFAYETTE, IN 47906-2766
(765) 743-3779
(765) 743-8767
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12010165
IN
122300000X
Dentist
12010165A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200270720B
—
IN
Enumeration date
11/21/2006
Last updated
07/08/2008
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