Organization
RED OAK FAMILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATRINA ANDRADA LEANO DDS (DENTIST/OWNER)
(651) 226-1029
Entity
Organization
Contact information
Practice address
9939 HUDSON BLVD N # 107, LAKE ELMO, MN 55042-4109
(651) 300-2334
Mailing address
9090 RED OAK TRL, WOODBURY, MN 55129-2210
(651) 226-1029
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
261QD0000X
Dental Clinic/Center
—
—
Other
Enumeration date
05/31/2019
Last updated
05/31/2019
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