Individual
ALISA S. DYKSTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
700 COLUMBINE ST, STERLING, CO 80751-3728
(970) 474-2619
Mailing address
782 5TH ST, CHAPPELL, NE 69129-6891
(308) 874-2203
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
10216
KS
124Q00000X
Dental Hygienist
1454
NE
124Q00000X
Dental Hygienist
Primary
903692
CO
Other
Enumeration date
07/08/2013
Last updated
07/08/2013
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