Organization
VALLEY RIDGE DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHAD LOWEEN D.D.S. (CO-OWNER)
(651) 766-5771
Entity
Organization
Contact information
Practice address
12425 55TH ST N, LAKE ELMO, MN 55042-7403
(651) 439-0322
Mailing address
4666 DALE ST N, SHOREVIEW, MN 55126-6021
(651) 766-5771
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D11362
MN
Other
Enumeration date
05/04/2007
Last updated
06/23/2008
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