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Individual

MRS. LISA KRUCHASKI THOMPSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
7600 PARKLAWN, STE 101, EDINA, MN 55435
(952) 835-6000
(952) 835-7679
Mailing address
5600 BRISTOL LN, MINNETONKA, MN 55343
(612) 987-8605

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
10631
MN

Other

Enumeration date
02/22/2007
Last updated
07/08/2007
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