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Individual

DR. GARETT NATHANIEL KRUSE BARRY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
1702 W INTERNATIONAL SPEEDWAY BLVD # 660, DAYTONA BEACH, FL 32114-1304
(386) 252-9600
Mailing address
1702 W INTERNATIONAL SPEEDWAY BLVD # 660, DAYTONA BEACH, FL 32114-1304

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
25267
FL

Other

Enumeration date
05/04/2020
Last updated
07/27/2020
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