Sunrise River Dental PA

NPI #1942361324 in Wyoming, Minnesota

Provider Information

NPI Number: 1942361324
Entity Type: Organization
Organization Name: Sunrise River Dental PA
Primary Specialty: Dentist - General Practice
Enumeration Date: Dec 12, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 26357 FOREST BLVD
City: Wyoming
State: Minnesota
ZIP Code: 55092-8353
Phone: (651) 462-7017

Authorized Official

Name: THERESE RYDLUND
Title: CDA, RDA
Phone: (651) 462-7017

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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