| Kruckman Family Dentistry | |
|
141 Depot Dr Waconia MN 55387-1874 | |
| (952) 679-4461 | |
| Not Available |
| Full Name | Kruckman Family Dentistry |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 141 Depot Dr, Waconia, Minnesota |
| Authorized Official Name and Position | Jalissa Kruckman (OWNER) |
| Authorized Official Contact | 9526794461 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kruckman Family Dentistry 141 Depot Dr Waconia MN 55387-1874 Ph: (952) 679-4461 | Kruckman Family Dentistry 141 Depot Dr Waconia MN 55387-1874 Ph: (952) 679-4461 |
| NPI Number | 1457134785 |
|---|---|
| Provider Enumeration Date | 08/18/2023 |
| Last Update Date | 08/18/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457134785 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |