Organization
EDINA FAMILY DENTAL ASSOC., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VIRGIL M MYLAN D.D.S. (PRESIDENT)
(952) 935-3532
Entity
Organization
Contact information
Practice address
4954 LINCOLN DR, EDINA, MN 55436-1071
(952) 935-3532
Mailing address
4954 LINCOLN DR, EDINA, MN 55436-1071
(952) 935-3532
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8250
MN
Other
Enumeration date
12/09/2006
Last updated
08/22/2020
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