Organization
EAGAN VALLEY PEDIATRICS, P.A.
Active
Organization
EAGAN VALLEY PEDIATRICS, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES E DUFORT M.D. (PRESIDENT)
(952) 432-4373
Entity
Organization
Contact information
Practice address
14135 CEDAR AVE, SUITE 100, APPLE VALLEY, MN 55124-4522
(952) 432-4373
(952) 997-5679
Mailing address
14135 CEDAR AVE, SUITE 100, APPLE VALLEY, MN 55124-4522
(952) 432-4373
(952) 997-5679
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
08/19/2005
Last updated
08/22/2020
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