Provider Demographics
NPI:1972897858
Name:CROUSE, ULLA KATRIINA (DDS, PHD)
Entity Type:Individual
Prefix:DR
First Name:ULLA
Middle Name:KATRIINA
Last Name:CROUSE
Suffix:
Gender:F
Credentials:DDS, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8641 W GRAND RIVER AVE
Mailing Address - Street 2:SUITE 9
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48116-4353
Mailing Address - Country:US
Mailing Address - Phone:810-229-8200
Mailing Address - Fax:810-220-5021
Practice Address - Street 1:8641 W GRAND RIVER AVE
Practice Address - Street 2:SUITE 9
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48116-4353
Practice Address - Country:US
Practice Address - Phone:810-229-8200
Practice Address - Fax:810-220-5021
Is Sole Proprietor?:No
Enumeration Date:2011-06-08
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010192491223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics