Organization
MODERN DENTAL PROFESSIONALS, MINNESOTA PC
Active
Other names
Midwest Dental
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY MOOS DDS (PRESIDENT)
(715) 926-5050
Entity
Organization
Contact information
Practice address
1853 MAIN ST, CENTERVILLE, MN 55038-9794
(651) 653-3272
(651) 653-3272
Mailing address
1853 MAIN ST, CENTERVILLE, MN 55038-9794
(651) 653-3272
(651) 653-3272
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
06/17/2010
Last updated
06/17/2010
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