Provider Demographics
NPI:1285678466
Name:KREKLAU, STEVEN AUGUST (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:AUGUST
Last Name:KREKLAU
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 1:8661 UPLAND LN N
Mailing Address - Street 2:
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55311
Mailing Address - Country:US
Mailing Address - Phone:763-494-3545
Mailing Address - Fax:
Practice Address - Street 1:7710 BROOKLYN BLVD
Practice Address - Street 2:STE 101
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55443-2966
Practice Address - Country:US
Practice Address - Phone:763-566-4910
Practice Address - Fax:763-560-7759
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNMN9373122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist