Healthcare Provider Details

I. General information

NPI: 1861311524
Provider Name (Legal Business Name): RLS FREEDOM DENTAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14120 COMMERCE AVE NE STE 300
PRIOR LAKE MN
55372-1503
US

IV. Provider business mailing address

14120 COMMERCE AVE NE STE 300
PRIOR LAKE MN
55372-1503
US

V. Phone/Fax

Practice location:
  • Phone: 763-227-1244
  • Fax:
Mailing address:
  • Phone: 763-227-1244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. RAYMOND LEE SEABURG
Title or Position: GENERAL DENTIST
Credential: DDS
Phone: 952-209-0747