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General NPI Number Information
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NPI Number | 1346049186
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Entity Type | Organization
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Legal Business Name | CORNER OAKS FAMILY DENTAL PLLC
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Dates
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Enumeration Date | 03/12/2025
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 290 EAGLE LAKE RD N
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City | BIG LAKE
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State | MN
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Zip | 55309-9243
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Country | US
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Telephone | 763-263-3262
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Fax |
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Provider Business Mailing Address
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Address Line | 6604 JONQUIL WAY
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City | MAPLE GROVE
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State | MN
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Zip | 55369-6048
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Country | US
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Telephone | 320-247-3380
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Fax |
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Authorized Official
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Title or Position | DENTIST OWNER
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Name | DR. PETER KUEFLER
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Credential | DDS
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Telephone | 320-247-3380
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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