Individual
DR. JOHN EUGENE ELVECROG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
8170 OLD CARRIAGE CT, SUITE 150, SHAKOPEE, MN 55379-3163
(952) 224-8090
(952) 224-8095
Mailing address
17977 LIV LN, EDEN PRAIRIE, MN 55346-4106
(952) 934-4762
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D11527
MN
Other
Enumeration date
10/10/2006
Last updated
07/08/2007
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