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General NPI Number Information
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NPI Number | 1184952996
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Entity Type | Organization
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Legal Business Name | GERALD KRAUSE, DDS, PA
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Dates
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Enumeration Date | 12/07/2009
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Last Update Date | 12/07/2009
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Provider Practice Location Address
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Address Line | 560 RIVERSIDE DR A205
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City | SALISBURY
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State | MD
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Zip | 21801-4700
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Country | US
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Telephone | 410-742-1688
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Fax | 410-742-2027
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Provider Business Mailing Address
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Address Line | 560 RIVERSIDE DR A205
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City | SALISBURY
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State | MD
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Zip | 21801-4700
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Country | US
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Telephone | 410-742-1688
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Fax | 410-742-2027
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. GERALD KRAUSE
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Credential | DDS
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Telephone | 410-742-1688
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 5002
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License Number State | MD
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