Individual
DR. KURT BRUKSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
690 NORTH ROUTE #31, CRYSTAL LAKE, IL 60012
(815) 459-5600
(815) 459-5601
Mailing address
690 NORTH ROUTE #31, CRYSTAL LAKE, IL 60012
(815) 459-5600
(815) 459-5601
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
019018137
IL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
3721
WI
Other
Enumeration date
08/03/2006
Last updated
06/23/2010
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