Organization
CD OHIO DERRICK KRUGER DDS, INC.
Active
Other names
Children's Dentistry of Middletown, Brockman, Pollock & Associates D.D.S.
Organization subpart
No
Provider details
NPI number
Authorized official
TY JUSTICE (DIRECTOR, CREDENTIALING)
(513) 808-4984
Entity
Organization
Contact information
Practice address
210 S BREIEL BLVD, MIDDLETOWN, OH 45044-5157
(513) 423-9239
(513) 423-4188
Mailing address
9825 KENWOOD RD STE 200, BLUE ASH, OH 45242-6252
(513) 808-4984
(513) 448-0511
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223G0001X
General Practice Dentistry
—
—
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
10/07/2022
Last updated
05/25/2023
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