| NPI | 1457134785 |
|---|---|
| Other Name | KRUCKMAN FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | JALISSA KRUCKMAN Owner 952-679-4461 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2023-08-18 |
| Last Update Date | 2023-08-18 |