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Jalissa Joy Kruckman, DDS
General Practice Dentistry in Waconia, Minnesota
NPI 1114238821

Jalissa Joy Kruckman is a General Practice Dentistry based in Waconia, MN and is specialized in General Practice. Jalissa Joy Kruckman practices in Waconia, MN and has the professional credentials of DDS. The NPI Number for Jalissa Joy Kruckman is 1114238821 and holds a License No. D12793 (Minnesota).

The current practice location address for Jalissa Joy Kruckman is 576 Cherry Dr, Waconia, MN and can be reached out via phone at 952-679-4461.

Location: 576 Cherry Dr, Waconia, MN, 55387-4578
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1114238821
Provider Name
Jalissa Joy Kruckman
Credential
DDS
Provider Entity Type
Individual
Gender
Female
Address
576 Cherry Dr, Waconia, MN, 55387-4578
Phone Number
952-679-4461
Fax Number
Provider Enumeration Date
06/28/2010
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
576 Cherry Dr
City
Waconia
State
Minnesota
Zip
55387
Phone Number
952-679-4461
Fax Number
person
Provider Business Mailing Address Details
Address
576 Cherry Dr
City
Waconia
State
Minnesota
Zip
55387
Phone Number
952-679-4461
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
D12793 (Minnesota)
Definition
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.
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