MEDICARE: DAVID HARVIEUX DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	D11057	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	014824500	OTHER	MN	MN CARE ID

General Provider Information

NPI Number	:	1487643706
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID HARVIEUX DDS

Provider Business Mailing Address
First Line	:	700 WESTON RIDGE PKWY
Second Line	:
City	:	CHASKA
State	:	MN
Zip	:	55318-1202
Country	:	US
Telephone Number	:	952-368-3356
Fax Number	:

Provider Business Practice Location Address
First Line	:	425 2ND ST
Second Line	:
City	:	EXCELSIOR
State	:	MN
Zip	:	55331-2038
Country	:	US
Telephone Number	:	952-474-6133
Fax Number	:	952-474-7361

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/19/2005
Last Update Date	:	03/22/2018

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