| Creekside Dental Pllc | |
|
3340 Republic Ave Ste 130 St Louis Park MN 55426-4189 | |
| (763) 442-7624 | |
| Not Available |
| Full Name | Creekside Dental Pllc |
|---|---|
| Speciality | Dentist |
| Location | 3340 Republic Ave Ste 130, St Louis Park, Minnesota |
| Authorized Official Name and Position | Gabriel De Los Rios (OWNER/DENTIST) |
| Authorized Official Contact | 7634427624 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Creekside Dental Pllc 12445 Porcupine Ct Eden Prairie MN 55344-3972 Ph: (612) 327-3331 | Creekside Dental Pllc 3340 Republic Ave Ste 130 St Louis Park MN 55426-4189 Ph: (763) 442-7624 |
| NPI Number | 1043955412 |
|---|---|
| Provider Enumeration Date | 05/01/2022 |
| Last Update Date | 05/01/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043955412 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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