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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 W. MOOS DDS (OWNER)
(715) 829-2791
Entity
Organization
Contact information
Practice address
1625 LENA CT, SUITE 100, EAGAN, MN 55122-2959
(651) 452-4111
(651) 452-8824
Mailing address
1625 LENA CT, SUITE 100, EAGAN, MN 55122-2959
(651) 452-4111
(651) 452-8824
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/06/2015
Last updated
10/06/2015
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