Provider Demographics
NPI:1174786545
Name:KRAKLOW, DONNA G (DDS)
Entity type:Individual
Prefix:DR
First Name:DONNA
Middle Name:G
Last Name:KRAKLOW
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 1:1507 E SUNSET DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53189-8203
Mailing Address - Country:US
Mailing Address - Phone:262-547-4433
Mailing Address - Fax:262-547-2977
Practice Address - Street 1:1507 E SUNSET DR
Practice Address - Street 2:SUITE 110
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53189-8203
Practice Address - Country:US
Practice Address - Phone:262-547-4433
Practice Address - Fax:262-547-2977
Is Sole Proprietor?:No
Enumeration Date:2008-07-07
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI47320151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice