Most Relevant Information
Provider Data
| NPI Number: | 1003009903 |
| Provider Name: | RYAN K VANLAECKEN D.D.S. M.S. |
| Entity Type: | Individual |
| Taxonomy Code: | 1223X0400X |
| Specialty: | Dentist |
| License Number: | M817 |
Most Important Dates
| Enumeration Date: | 08/23/2007 |
| Last Updated: | 05/19/2020 |
Provider Practice Location
600 4TH ST NE STE 103
WATERTOWN
SD
572011898
Practice Location Phone/Fax
| Phone: | 6058821500 |
| Fax: | 6058827090 |
Provider Mailing Location
25 5TH ST NE
P O BOX 1450
WATERTOWN
SD
572013712
Provider Mailing Phone/Fax
| Phone: | 6058821500 |
| Fax: | 6058827090 |