Organization
EAGAN VALLEY DENTAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN DAVID MITTELSTEADT DDS (PRESIDENT)
(952) 423-4414
Entity
Organization
Contact information
Practice address
14050 PILOT KNOB RD, APPLE VALLEY, MN 55124-6647
(952) 423-4414
Mailing address
14050 PILOT KNOB RD, APPLE VALLEY, MN 55124-6647
(952) 423-4414
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
9922
MN
Other
Enumeration date
06/26/2013
Last updated
06/26/2013
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