Eagle Grove Family Dentistry Plc

NPI #1831566330 in Eagle Grove, Iowa

Provider Information

NPI Number: 1831566330
Entity Type: Organization
Organization Name: Eagle Grove Family Dentistry Plc
Primary Specialty: Dentist
Enumeration Date: Sep 1, 2015
Last Updated: Sep 1, 2015

Practice Location

Address: 306 W BROADWAY ST
City: Eagle Grove
State: Iowa
ZIP Code: 50533-1712
Phone: (515) 448-5022

Authorized Official

Name: DR. MYSTY SHAVER, DDS
Title: OWNER/DENTIST
Phone: (515) 448-5022

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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