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NPI Code Detail

MEDICARE: DR. LARRY KREUGER DDS

MEDICARE: DR. LARRY KREUGER DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist9210MN

General Provider Information

NPI Number : 1174696835
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LARRY KREUGER DDS
Provider Business Mailing Address
First Line : 5851 DULUTH ST STE 218
Second Line :
City : GOLDEN VALLEY
State : MN
Zip : 55422-3956
Country : US
Telephone Number : 763-544-0121
Fax Number :
Provider Business Practice Location Address
First Line : 5851 DULUTH ST STE 218
Second Line :
City : GOLDEN VALLEY
State : MN
Zip : 55422-3956
Country : US
Telephone Number : 763-544-0121
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2006
Last Update Date : 07/08/2007

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Directions to “ DR. LARRY KREUGER DDS” Practice Location

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