Organization
MODERN DENTAL PROFESSIONALS MN PC
Active
Other names
Midwest Dental
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY MOOS DDS (CEO)
(715) 926-5050
Entity
Organization
Contact information
Practice address
226 MAIN ST S, CHATFIELD, MN 55923-1225
(507) 867-3550
Mailing address
431 MAIN ST N, SUITE B, CHATFIELD, MN 55923-1176
(507) 867-3550
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D11386
MN
Other
Enumeration date
12/17/2007
Last updated
05/18/2009
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