Organization
DONALD E KRAUSE DDS LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD E KRAUSE DDS (PRESIDENT)
(815) 937-3521
Entity
Organization
Contact information
Practice address
555 W COURT ST, SUITE 102, KANKAKEE, IL 60901-3664
(815) 937-3521
(815) 802-1264
Mailing address
555 W COURT ST, SUITE 102, KANKAKEE, IL 60901-3664
(815) 937-3521
(815) 802-1264
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
019018002
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101470
—
IL
Enumeration date
12/14/2009
Last updated
12/14/2009
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