Provider Demographics
NPI:1477170108
Name:JESSE N VEIL DDS MS PA
Entity Type:Organization
Organization Name:JESSE N VEIL DDS MS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:NARVAEZ
Authorized Official - Suffix:
Authorized Official - Credentials:RDH
Authorized Official - Phone:952-903-9484
Mailing Address - Street 1:11800 SINGLETREE LN STE 200
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-5397
Mailing Address - Country:US
Mailing Address - Phone:952-903-9484
Mailing Address - Fax:
Practice Address - Street 1:250 FULLER ST S STE 100
Practice Address - Street 2:
Practice Address - City:SHAKOPEE
Practice Address - State:MN
Practice Address - Zip Code:55379-1324
Practice Address - Country:US
Practice Address - Phone:952-903-9484
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-29
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty