NPI | 1124575501 |
---|---|
Former Legal Business Name | GEORGE DENTAL EAGAN, PA |
Other Name | GEORGE DENTAL GROUP, PA |
Entity Type | Organization |
Authorized Contact | KELLEE STANTON Dentist/Owner 651-343-7002 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2016-09-02 |
Last Update Date | 2024-08-12 |