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General NPI Number Information
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NPI Number | 1578193983
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Entity Type | Organization
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Legal Business Name | JACK T KRAUSER DMD PLLC
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Dates
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Enumeration Date | 01/24/2020
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Last Update Date | 01/24/2020
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Provider Practice Location Address
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Address Line | 824 US HIGHWAY 1 STE 370
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City | N PALM BEACH
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State | FL
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Zip | 33408-3861
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Country | US
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Telephone | 561-627-5560
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Fax |
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Provider Business Mailing Address
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Address Line | 824 US HIGHWAY 1 STE 370
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City | N PALM BEACH
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State | FL
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Zip | 33408-3861
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JACK T KRASUSER
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Credential | DMD
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Telephone | 561-627-5560
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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