Individual
KEVIN L RIECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MD
Contact information
Practice address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
38472
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
573316200
—
MN
Enumeration date
01/17/2006
Last updated
04/23/2014
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