Provider Demographics
NPI:1003256876
Name:LAU, EVA (DDS)
Entity Type:Individual
Prefix:
First Name:EVA
Middle Name:
Last Name:LAU
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7890 MITCHELL RD
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-2219
Mailing Address - Country:US
Mailing Address - Phone:952-937-7677
Mailing Address - Fax:
Practice Address - Street 1:7890 MITCHELL RD
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55344-2219
Practice Address - Country:US
Practice Address - Phone:952-937-7677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-26
Last Update Date:2022-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013016299122300000X
MND13459122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist