Provider Demographics
NPI:1073639290
Name:KRAUSE, STEVEN E (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:E
Last Name:KRAUSE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:337 W MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-3407
Mailing Address - Country:US
Mailing Address - Phone:619-442-8841
Mailing Address - Fax:619-442-4214
Practice Address - Street 1:337 W MADISON AVE
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-3407
Practice Address - Country:US
Practice Address - Phone:619-442-8841
Practice Address - Fax:619-442-4214
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA223731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice