Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
SHANNON MARIE KRUCKEBERG, RDH
Active Sole ProprietorSHANNON MARIE KRUCKEBERG, RDH is a Dental Hygienist healthcare provider located in CLAREMONT, Minnesota. NPI 1003002882 is currently active in the NPPES registry. Verify at CMS.
Dental Hygienist · CLAREMONT, MN
Registration Details
- NPI Number
- 1003002882
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Sep 14, 2007 (18.89009857244 yrs)
- Last Updated
- Nov 16, 2009
- License
-
H6343 (MN)
- Sole Proprietor
- Yes
Practice Information
- Address
-
63407 130TH AVECLAREMONT, MN, 559244656Browse MN providers · Browse ZIP 55924
- Phone
- 5073196845
- Primary Specialty
-
Dental Hygienist
124Q00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.