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Individual

KRISTIN MARIE RIVERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
5000 W 36TH ST STE 250, ST LOUIS PARK, MN 55416-2776
(612) 467-6555
Mailing address
5000 W 36TH ST STE 250, ST LOUIS PARK, MN 55416-2776
(952) 920-3700

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
DN21507
FL
122300000X
Dentist
R615
MN
1223G0001X
General Practice Dentistry
Primary
D13645
MN

Other

Enumeration date
11/23/2015
Last updated
10/03/2019
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