Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

South River Dental PLLC

Organization Dental Clinic/Center · NPI 1154066405

South River Dental PLLC is a Dental Clinic/Center in West St Paul, Minnesota. Registered with an NPI since 2022.

In the registry since
2022
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1545 Livingston Ave Ste 101
West St Paul, MN 55118-3422
Phone: (651) 455-0505
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dental Clinic/Center (primary) Taxonomy 261QD0000X

Record details

NPI number1154066405
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Clint Kroeker — President · (651) 455-0505
NPI enumeratedMay 2, 2022
Last updated in NPPESMay 2, 2022
Certification dateMay 2, 2022
Mailing address1545 Livingston Ave Ste 101, West St Paul, MN 55118-3422

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