Organization
RIVERS EDGE DENTAL CLINIC, PLLC
Active
Parent organization
RIVERS EDGE DENTAL CLINIC, PLLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
RIVERS EDGE DENTAL CLINIC, PLLC
Authorized official
DR. JESSICA ANN TRI DDS (OWNER)
(952) 232-6454
Entity
Organization
Contact information
Practice address
16023 ELMHURST LN STE 104, LAKEVILLE, MN 55044-4791
(952) 232-6454
(651) 460-6123
Mailing address
16023 ELMHURST LN STE 104, LAKEVILLE, MN 55044-4791
(952) 232-6454
(651) 460-6123
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
08/15/2018
Last updated
08/15/2018
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