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General NPI Number Information
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NPI Number | 1235615022
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Entity Type | Individual
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Provider Name | CLAIRE KRUEGER MARTUCCI DDS
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Gender | Female
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Dates
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Enumeration Date | 07/14/2018
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Last Update Date | 09/09/2019
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Provider Practice Location Address
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Address Line | 1395 CENTER DR RM D1-17
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City | GAINESVILLE
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State | FL
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Zip | 32610-2800
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Country | US
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Telephone | 352-273-5430
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Fax |
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Provider Business Mailing Address
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Address Line | 2000 SW 16TH ST APT 1
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City | GAINESVILLE
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State | FL
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Zip | 32608-1437
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Country | US
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Telephone | 727-776-5967
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | DRPM1879
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License Number State | FL
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