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NPI Profile for JALISSA J KRUCKMAN in WACONIA, MN.
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
General Practice |
1223G0001X |
| NPI # | 1114238821 |
|
| Status | Active | |
| Credentials | DDS (Doctor of Dental Surgery) | |
| Entity | Individual | |
| Enumeration date | 06/28/2010 | |
| Last updated | 07/16/2018 - About 8 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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JALISSA J KRUCKMAN
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JALISSA J KRUCKMAN, DDS