Individual
ANNA DIERKING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
12 LONG LAKE RD STE 12, SAINT PAUL, MN 55115-1200
(651) 770-2699
Mailing address
12 LONG LAKE RD STE 12, MAHTOMEDI, MN 55115-1200
(651) 770-2699
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
MN
Other
Enumeration date
05/19/2021
Last updated
06/09/2022
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