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General NPI Number Information
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NPI Number | 1730818261
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Entity Type | Individual
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Provider Name | ANN KRUG DMD
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Gender | Female
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Dates
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Enumeration Date | 06/09/2022
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Last Update Date | 06/09/2022
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Provider Practice Location Address
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Address Line | 1636 N 51ST AVE
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City | PHOENIX
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State | AZ
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Zip | 85035-3936
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Country | US
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Telephone | 602-904-5901
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Fax |
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Provider Business Mailing Address
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Address Line | 9445 W POTTER DR
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City | PEORIA
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State | AZ
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Zip | 85382-5306
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Country | US
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Telephone | 248-504-1944
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | D011419
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License Number State | AZ
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