Healthcare Provider Details

I. General information

NPI: 1902791619
Provider Name (Legal Business Name): EUPHROSYNE IRENE DAOUTIDOU DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2025
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13961 60TH ST N
STILLWATER MN
55082-1053
US

IV. Provider business mailing address

9000 CITY PLACE BLVD
WOODBURY MN
55125-5513
US

V. Phone/Fax

Practice location:
  • Phone: 651-439-2600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberD15294
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: