Organization
MODERN DENTAL PROFESSIONALS MINNESOTA PC
Active
Other names
Midwest Dental
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES MYER (CFO)
(715) 926-5050
Entity
Organization
Contact information
Practice address
1405 78TH ST, VICTORIA, MN 55386-9723
(952) 443-2994
(952) 443-2918
Mailing address
1405 78TH ST, VICTORIA, MN 55386-9723
(952) 443-2994
(952) 443-2918
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/02/2009
Last updated
12/02/2009
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