Individual
DR. KEVIN ROBERT FRUIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2201 N BROADWELL AVE, GRAND ISLAND, NE 68803-2153
(308) 382-3660
Mailing address
2201 N BROADWELL AVE, GRAND ISLAND, NE 68803-2153
(308) 382-3660
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6194
NE
Other
Enumeration date
06/12/2006
Last updated
07/13/2007
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