Individual
JASON MICHAEL KUESTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1331 W BOONVILLE NEW HARMONY RD, EVANSVILLE, IN 47725-9583
(812) 867-6428
(812) 867-7494
Mailing address
1331 W BOONVILLE NEW HARMONY RD, EVANSVILLE, IN 47725-9583
(812) 867-6428
(812) 867-7494
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12011322-A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
IN
Enumeration date
07/01/2009
Last updated
07/01/2009
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