Provider Demographics
NPI:1629237334
Name:KRUEGER, REBECCA RAE (DDS)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:RAE
Last Name:KRUEGER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 S 40TH ST STE 218
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-5247
Mailing Address - Country:US
Mailing Address - Phone:402-483-1054
Mailing Address - Fax:402-892-7054
Practice Address - Street 1:1919 S 40TH ST STE 218
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-5247
Practice Address - Country:US
Practice Address - Phone:402-483-1054
Practice Address - Fax:402-892-7054
Is Sole Proprietor?:No
Enumeration Date:2008-06-06
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE67621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice