| Rivers Edge Dental Clinic, Pllc | |
|
16023 Elmhurst Ln Ste 104 Lakeville MN 55044-4791 | |
| (952) 232-6454 | |
| (651) 460-6123 |
| Full Name | Rivers Edge Dental Clinic, Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 16023 Elmhurst Ln Ste 104, Lakeville, Minnesota |
| Authorized Official Name and Position | Jessica Ann Tri (OWNER) |
| Authorized Official Contact | 9522326454 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rivers Edge Dental Clinic, Pllc 16023 Elmhurst Ln Ste 104 Lakeville MN 55044-4791 Ph: (952) 232-6454 | Rivers Edge Dental Clinic, Pllc 16023 Elmhurst Ln Ste 104 Lakeville MN 55044-4791 Ph: (952) 232-6454 |
| NPI Number | 1750861258 |
|---|---|
| Provider Enumeration Date | 08/15/2018 |
| Last Update Date | 08/15/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750861258 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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