Individual
LISEN A. KRUEGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
01 SAGEBRUSH RD., ISLETA, NM 87022
(505) 869-3200
(505) 869-4881
Mailing address
PO BOX 640, ISLETA, NM 87022-0640
(505) 869-3200
(505) 869-4881
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH3728
NM
Other
Enumeration date
05/08/2013
Last updated
05/08/2013
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