Krueger, Mary Melissa

Krueger, Mary Melissa is an individual health care provider with primary practice located at 200 S Executive Dr Suite 101, Brookfield WI 53005-4216. She recently has only one registered license in Dental Providers / Dental Hygienist, which is considered as her primary health care specialty. Krueger, Mary Melissa can be contacted via phone (414) 535-8134.

Contact Information

Primary practice address
200 S Executive Dr Suite 101 Brookfield WI 53005-4216
Phone: (414) 535-8134
Fax: (888) 662-0859
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dental Hygienist 124Q00000X 3941-016 Wisconsin

Profile Details

NPI number 1891985602
LBN Legal business name Krueger, Mary Melissa
Credentials Registered Dental Hygienist (RDH)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 27th, 2007
Last updated Oct 19th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891985602 NPPES
Wisconsin MEDICAID 33825100

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