Individual
DR. JOHN JACOB KUSSMAUL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
934 RICHARD RD, DYER, IN 46311-1936
(219) 865-9790
(219) 865-9792
Mailing address
934 RICHARD RD, DYER, IN 46311-1936
(219) 865-9790
(219) 865-9792
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
12007811A
IN
Other
Enumeration date
03/19/2007
Last updated
11/30/2009
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