Individual
LISA ANNE RUNCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS. MS
Contact information
Practice address
120 E MAIN ST, MANKATO, MN 56001-3501
(507) 388-2989
(507) 388-2985
Mailing address
120 E MAIN ST, MANKATO, MN 56001-3501
(507) 388-2989
(507) 388-2985
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
11289
MN
Other
Enumeration date
11/28/2006
Last updated
07/08/2007
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