Organization
EAGAN FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY A. RUD D.D.S. (PRESIDENT)
(651) 452-4317
Entity
Organization
Contact information
Practice address
4178 KNOB DR STE C, EAGAN, MN 55122-1875
(651) 452-4317
(651) 452-2208
Mailing address
4178 KNOB DR STE C, EAGAN, MN 55122-1875
(651) 452-4317
(651) 452-2208
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9966
MN
Other
Enumeration date
03/13/2007
Last updated
08/22/2020
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