Provider Demographics
NPI:1760848527
Name:KRAUSE DENTAL
Entity type:Organization
Organization Name:KRAUSE DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:JESS
Authorized Official - Last Name:KRAUSE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:941-923-3802
Mailing Address - Street 1:7208 BENEVA ROAD SOUTH
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34238
Mailing Address - Country:US
Mailing Address - Phone:941-923-3802
Mailing Address - Fax:941-923-3791
Practice Address - Street 1:7208 BENEVA ROAD SOUTH
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34238
Practice Address - Country:US
Practice Address - Phone:941-923-3802
Practice Address - Fax:941-923-3791
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-11
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN18310122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty