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Organization

RIVERSIDE FAMILY DENTAL, P.A.

Active
Other names
Riverside Family Dental, P.A.
Organization subpart
No

Provider details

NPI number
Authorized official
KAMAL M FAKHREDDINE DDS (OWNER/PRESIDENT)
(763) 427-7930
Entity
Organization

Contact information

Practice address
2006 1ST AVE STE 202, ANOKA, MN 55303-2255
(763) 427-7930
(763) 427-7537
Mailing address
2006 1ST AVE STE 202, ANOKA, MN 55303-2255
(763) 427-7930

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Enumeration date
03/27/2023
Last updated
03/27/2023
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