Organization
MODERN DENTAL PROFESSIONALS, MN PC
Active
Other names
Midwest Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY W MOOS DDS (CEO)
(715) 926-5050
Entity
Organization
Contact information
Practice address
507 S SHORE DR, WORTHINGTON, MN 56187-1400
(507) 372-2072
(507) 372-2362
Mailing address
507 S SHORE DR, WORTHINGTON, MN 56187-1400
(507) 372-2072
(507) 372-2362
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/18/2011
Last updated
05/18/2011
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