| NPI | 1568673366 |
|---|---|
| Former Name | KELLY SUE KREUTER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: OH 30.022717) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: OH 30-022717) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: OH 2322) | |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2019-12-19 |