Provider Demographics
NPI:1093841009
Name:KRAKAUER, THOMAS B (DMD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:B
Last Name:KRAKAUER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14050 NW 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33168-6809
Mailing Address - Country:US
Mailing Address - Phone:305-688-7989
Mailing Address - Fax:305-681-7948
Practice Address - Street 1:14050 NW 7TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33168-6809
Practice Address - Country:US
Practice Address - Phone:305-688-7989
Practice Address - Fax:305-681-7948
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN000096521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice