Individual
LEEANN DIERCKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
20 19TH ST SE, WATERTOWN, SD 57201-3938
(605) 886-2805
Mailing address
20 19TH ST SE, PO BOX 330, WATERTOWN, SD 57201-3938
(605) 886-2805
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D1113
SD
122300000X
Dentist
D13356
MN
Other
Enumeration date
05/19/2014
Last updated
06/22/2016
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