Provider Demographics
NPI:1831102359
Name:KRUG, EARL GEORGE (DMD)
Entity Type:Individual
Prefix:DR
First Name:EARL
Middle Name:GEORGE
Last Name:KRUG
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 1:75 MALL RD
Mailing Address - Street 2:
Mailing Address - City:ETTERS
Mailing Address - State:PA
Mailing Address - Zip Code:17319-9500
Mailing Address - Country:US
Mailing Address - Phone:717-938-5757
Mailing Address - Fax:
Practice Address - Street 1:75 MALL RD
Practice Address - Street 2:
Practice Address - City:ETTERS
Practice Address - State:PA
Practice Address - Zip Code:17319-9500
Practice Address - Country:US
Practice Address - Phone:717-938-5757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS024175L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice