Provider Demographics
NPI:1891808531
Name:KRULEWECKI, ADRIAN GUSTAVO (DDS)
Entity Type:Individual
Prefix:
First Name:ADRIAN
Middle Name:GUSTAVO
Last Name:KRULEWECKI
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 1:1414 SOUTH MILLER ST
Mailing Address - Street 2:SUITE #8
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454
Mailing Address - Country:US
Mailing Address - Phone:805-922-5122
Mailing Address - Fax:805-922-5333
Practice Address - Street 1:1414 SOUTH MILLER ST
Practice Address - Street 2:SUITE #8
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454
Practice Address - Country:US
Practice Address - Phone:805-922-5122
Practice Address - Fax:805-922-5333
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49127122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist