Organization
EV DENTAL P.A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN D MITTELSTEADT DDS (OWNER)
(651) 681-9044
Entity
Organization
Contact information
Practice address
12401 NICOLLET AVE, BURNSVILLE, MN 55337-4859
(952) 890-4255
Mailing address
12401 NICOLLET AVE, BURNSVILLE, MN 55337-4859
(952) 890-4255
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D9630
MN
Other
Enumeration date
03/02/2017
Last updated
03/02/2017
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