Organization
RIVERDALE KIDDS PEDIATRIC DENTISTRY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEANN CARLSON (FINANCIAL COORDINATOR)
(763) 283-5494
Entity
Organization
Contact information
Practice address
3585 124TH AVE NW STE 400, COON RAPIDS, MN 55433-1008
(763) 283-5494
Mailing address
3585 124TH AVE NW STE 400, COON RAPIDS, MN 55433-1008
(763) 767-1524
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
12/21/2018
Last updated
12/21/2018
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