Eagan Valley Dental Center P.a.

NPI #1902146335 in Eagan, Minnesota

Provider Information

NPI Number: 1902146335
Entity Type: Organization
Organization Name: Eagan Valley Dental Center P.a.
Primary Specialty: Dentist
Enumeration Date: Feb 21, 2013
Last Updated: Feb 21, 2013

Practice Location

Address: 4555 ERIN DR
City: Eagan
State: Minnesota
ZIP Code: 55122-3398
Phone: (651) 681-9044

Authorized Official

Name: DR. JOHN DAVID MITTELSTEADT
Title: PRESIDENT
Phone: (651) 681-9044

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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