Individual
DR. JAMES ELIASEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1205 20TH ST S, VIRGINIA, MN 55792-3724
(218) 741-0901
Mailing address
1205 20TH ST S, VIRGINIA, MN 55792-3724
(218) 741-0901
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D7942
MN
Other
Enumeration date
11/17/2012
Last updated
11/17/2012
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