| NPI | 1548690001 |
|---|---|
| Doing Business As | RIVERSIDE DENTAL |
| Entity Type | Organization |
| Authorized Contact | JENNIFER COLLETTE Office Administrator 952-938-2740 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN 9089) |
| Enumeration Date | 2013-11-20 |
| Last Update Date | 2013-11-20 |