Individual
ALEXA NICOLE WEISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LDH
Contact information
Practice address
602 N JACKSON AVE, SPRINGFIELD, MN 56087-4502
(507) 723-4375
Mailing address
602 N JACKSON AVE, SPRINGFIELD, MN 56087-4502
(507) 723-4375
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
H11217
MN
125J00000X
Dental Therapist
Primary
DT145
MN
Other
Enumeration date
01/31/2022
Last updated
06/28/2022
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