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Organization
RIVERSIDE FAMILY DENTAL, P.A.
Active
Organization
RIVERSIDE FAMILY DENTAL, P.A.
Active
Other names
Riverside Family Dental, P.A.
Organization subpart
No
Provider details
NPI number
Authorized official
KAMAL M FAKHREDDINE DDS (OWNER/PRESIDENT)
(763) 427-7930
Entity
Organization
Contact information
Practice address
2006 1ST AVE STE 202, ANOKA, MN 55303-2255
(763) 427-7930
(763) 427-7537
Mailing address
2006 1ST AVE STE 202, ANOKA, MN 55303-2255
(763) 427-7930
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
03/27/2023
Last updated
03/27/2023
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