Individual
ALICIA BRIANNE KNIEPKAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
1501 W JEFFERSON ST, VANDALIA, IL 62471-1509
(618) 580-5439
Mailing address
1501 W JEFFERSON ST, VANDALIA, IL 62471-1509
(618) 580-5439
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
020.014339
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020.014339
DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION
IL
Enumeration date
03/17/2021
Last updated
03/17/2021
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