Organization
KROUSE-EVANS, INC.
Active
Other names
Defiance Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BRANDI EBERLE (OFFICE MANAGER)
(419) 782-7950
Entity
Organization
Contact information
Practice address
245 STADIUM DR, DEFIANCE, OH 43512-4604
(419) 782-7950
(419) 782-8880
Mailing address
245 STADIUM DR, DEFIANCE, OH 43512-4604
(419) 782-7950
(419) 782-8880
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30013385
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0415250
—
OH
Enumeration date
12/03/2008
Last updated
12/03/2008
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