| Eagan Valley Dental Center P.a. | |
|
4555 Erin Dr Eagan MN 55122-3398 | |
| (651) 681-9044 | |
| (651) 681-0599 |
| Full Name | Eagan Valley Dental Center P.a. |
|---|---|
| Speciality | Dentist |
| Location | 4555 Erin Dr, Eagan, Minnesota |
| Authorized Official Name and Position | John David Mittelsteadt (PRESIDENT) |
| Authorized Official Contact | 6516819044 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eagan Valley Dental Center P.a. 4555 Erin Dr Eagan MN 55122-3398 Ph: (651) 681-9044 | Eagan Valley Dental Center P.a. 4555 Erin Dr Eagan MN 55122-3398 Ph: (651) 681-9044 |
| NPI Number | 1902146335 |
|---|---|
| Provider Enumeration Date | 02/21/2013 |
| Last Update Date | 02/21/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902146335 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 09922 (Minnesota) | Primary |
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