| NPI | 1245250596 |
|---|---|
| Doing Business As | EAGLE VALLEY DENTAL |
| Entity Type | Organization |
| Authorized Contact | MARJAN JAVANMARDIAN Dentist/Owner 651-200-4747 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MN L11291) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2017-02-07 |