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Search › Minnesota › General Practice Dentistry

Jalissa Kruckman, DDS

NPI 1114238821 · on the registry since 2010 · sole proprietor

Practice

Address
576 Cherry Dr
Waconia, MN 55387
Phone
(952) 679-4461
Clinicians at this address
2

Registry record

Primary taxonomy
General Practice Dentistry
1223G0001X
Licence states on file
MN
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2018-07-16
Status
Not present in the most recent federal file

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Minnesota