Organization
MORA DENTAL CENTER LLC
Active
Other names
Mora Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JENNIFER VANDERPOEL DDS (PRESIDENT)
(320) 679-2147
Entity
Organization
Contact information
Practice address
547 UNION ST S, MORA, MN 55051-1875
(320) 679-2147
(320) 679-2101
Mailing address
547 UNION ST S, MORA, MN 55051
(320) 679-2147
(320) 679-2101
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D11774
MN
Other
Enumeration date
02/24/2017
Last updated
02/24/2017
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