Individual
JOHN DAVID MITTELSTEADT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
4555 ERIN DR, EAGAN, MN 55122-3398
(651) 681-9044
Mailing address
4555 ERIN DR, EAGAN, MN 55122-3398
(651) 681-9044
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
09922
MN
Other
Enumeration date
09/26/2006
Last updated
07/08/2007
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