Bart J Kraus, DDS
Individual provider Active NPI Dentist · Whitewater, WI
NPI 1104095108 · NPPES record last updated Feb 22, 2008
Key facts
- NPI
- 1104095108
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 3486 (WI)
- Practice address
- 301 W Main St
Whitewater, WI 53190-1957 - Phone
- (262) 473-3700
- Fax
- (262) 473-3718
- NPI assigned
- Feb 22, 2008
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 3486 | WI | Yes |
Addresses
Primary practice location
301 W Main St
Whitewater, WI 53190-1957
Mailing address
301 W Main St
Whitewater, WI 53190-1957
Phone (262) 473-3700
Other providers in Whitewater, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 22, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.