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Organization
MODERN DENTAL PROFESSIONALS MN PC
Active
Organization
MODERN DENTAL PROFESSIONALS MN PC
Active
Other names
Midwest Dental
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY MOOS DDS (OWNER)
(715) 829-2791
Entity
Organization
Contact information
Practice address
195 JEFFERSON BLVD, BIG LAKE, MN 55309-9572
(763) 280-5711
(763) 263-5822
Mailing address
195 JEFFERSON BLVD, BIG LAKE, MN 55309-9572
(763) 280-5711
(763) 263-5822
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/05/2015
Last updated
10/05/2015
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