NPI 1003002882

Shannon Marie Kruckeberg, RDH

Practitioner Dental Hygienist Claremont, MN

Practice location

Address: 63407 130th Ave, Claremont, MN 55924-4656
Phone: (507) 319-6845

Registered specialties

Dental Hygienist Primary

Dental Providers Taxonomy 124Q00000X Licence H6343 (MN)

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Registry record

NPI: 1003002882
Entity type: Individual
Sex (as registered): Female
NPI issued: 14 Sep 2007
Record last updated: 16 Nov 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.