Provider Demographics
NPI:1902968530
Name:KRUYER, ANNALEE SUSAN (DDS, FAGD)
Entity Type:Individual
Prefix:DR
First Name:ANNALEE
Middle Name:SUSAN
Last Name:KRUYER
Suffix:
Gender:F
Credentials:DDS, FAGD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8925 W RUSSELL RD
Mailing Address - Street 2:SUITE #160
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-1219
Mailing Address - Country:US
Mailing Address - Phone:702-732-2223
Mailing Address - Fax:702-433-2247
Practice Address - Street 1:8925 W RUSSELL RD
Practice Address - Street 2:SUITE #160
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-1219
Practice Address - Country:US
Practice Address - Phone:702-732-2223
Practice Address - Fax:702-433-2247
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4574122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist