Provider Demographics
NPI:1346049186
Name:CORNER OAKS FAMILY DENTAL PLLC
Entity type:Organization
Organization Name:CORNER OAKS FAMILY DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:KUEFLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:320-247-3380
Mailing Address - Street 1:6604 JONQUIL WAY
Mailing Address - Street 2:
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55369-6048
Mailing Address - Country:US
Mailing Address - Phone:320-247-3380
Mailing Address - Fax:
Practice Address - Street 1:290 EAGLE LAKE RD N
Practice Address - Street 2:
Practice Address - City:BIG LAKE
Practice Address - State:MN
Practice Address - Zip Code:55309-9243
Practice Address - Country:US
Practice Address - Phone:763-263-3262
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental