Organization
CREEKSIDE DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GABRIEL DE LOS RIOS DDS (OWNER/DENTIST)
(763) 442-7624
Entity
Organization
Contact information
Practice address
3340 REPUBLIC AVE STE 130, ST LOUIS PARK, MN 55426-4189
(763) 442-7624
Mailing address
12445 PORCUPINE CT, EDEN PRAIRIE, MN 55344-3972
(612) 327-3331
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
05/01/2022
Last updated
05/01/2022
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