| Eagan Dental Clinic | |
|
4640 Slater Rd Ste 150 Eagan MN 55122-4045 | |
| (651) 808-5252 | |
| (651) 808-5253 |
| Full Name | Eagan Dental Clinic |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4640 Slater Rd Ste 150, Eagan, Minnesota |
| Authorized Official Name and Position | Judy K. Pedro-lim (DENTIST) |
| Authorized Official Contact | 6518085252 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eagan Dental Clinic 4640 Slater Rd Ste 150 Eagan MN 55122-4045 Ph: (651) 808-5252 | Eagan Dental Clinic 4640 Slater Rd Ste 150 Eagan MN 55122-4045 Ph: (651) 808-5252 |
| NPI Number | 1942474457 |
|---|---|
| Provider Enumeration Date | 04/15/2008 |
| Last Update Date | 04/15/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942474457 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | () | Secondary |
| 1223G0001X | Dentist - General Practice | () | Primary |
| 1223P0221X | Dentist - Pediatric Dentistry | () | Secondary |
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