# DANIEL W KRUEGER AAS PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** LifeSmiles Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508931205
- **Authorized official:** DR. DANIEL W KRUEGER DDS (OWNER PRESIDENT)
- **Authorized official phone:** (765) 743-3779

## Contact information

- **Practice address:** 928 N ROBINSON, LIFESMILE DENTISTRY, WEST LAFAYETTE, IN 47906-2766
- **Practice address phone:** (765) 743-3779
- **Practice address fax:** (765) 743-8767
- **Mailing address:** 928 N ROBINSON, WEST LAFAYETTE, IN 47906-2766
- **Mailing address phone:** (765) 743-3779
- **Mailing address fax:** (765) 743-8767

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 12010165 | IN | Yes |
| 122300000X | Dentist | 12010165A | IN | — |

## Other

- **Enumeration date:** 11/21/2006
- **Last updated:** 07/08/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200270720B | — | IN |