| Organization Name: | EDWARD A. KRUKOWSKI, DMD, PA |
| NPI Number: | 1942692223 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | EDWARD A KRUKOWSKI (DENTIST) |
| Mailing Address: | 9801 Collins Ave #c-102 Bal Harbour |
| State: | FL US |
| Postal Code: | 331541815 |
| Phone Number: | 3058666662 |
| Fax Number: | 3058661144 |
| NPI Enumeration Date: | 02/24/2015 |
| NPI Last Update Date: | 02/24/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | DN11476 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |