Provider Demographics
NPI:1114009123
Name:KROOK, BRUCE C (DDS)
Entity Type:Individual
Prefix:MR
First Name:BRUCE
Middle Name:C
Last Name:KROOK
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 1:4650 TURNBERRY DR
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50265-5243
Mailing Address - Country:US
Mailing Address - Phone:515-224-1652
Mailing Address - Fax:
Practice Address - Street 1:1903 EP TRUE PKWY # S-301
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50265-7000
Practice Address - Country:US
Practice Address - Phone:515-224-1618
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA64741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice