Provider Demographics
NPI:1023075942
Name:KRUER, RICHARD D JR (DMD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:D
Last Name:KRUER
Suffix:JR
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 1:16 PATERSON PL
Mailing Address - Street 2:
Mailing Address - City:FORT THOMAS
Mailing Address - State:KY
Mailing Address - Zip Code:41075-1942
Mailing Address - Country:US
Mailing Address - Phone:859-781-9810
Mailing Address - Fax:
Practice Address - Street 1:2300 WAYNE MEMORIAL DR STE G
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-1747
Practice Address - Country:US
Practice Address - Phone:919-581-9770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH185891223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery